| NPI | 1821435249 |
|---|---|
| Former Name | SHANNA M MORTENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: AZ DA8426) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: AZ DA8426) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: CO 680) | |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2023-03-21 |