Basic Information
| Provider Information | |||||||||
| NPI: | 1023687001 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1377 DRESDEN DR NE APT 3255 | ||||||||
| Address2: | |||||||||
| City: | BROOKHAVEN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303193410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6625491402 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5461 MERIDIAN MARK RD STE 130 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303423009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045911884 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2021 | ||||||||
| LastUpdateDate: | 06/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AUD004284 | GA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.