Basic Information
| Provider Information | |||||||||
| NPI: | 1114222585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAULDING | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 HWY. 515 | ||||||||
| Address2: | SUITE D | ||||||||
| City: | BLAIRSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305127830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067450091 | ||||||||
| FaxNumber: | 7067450099 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 HWY. 515 | ||||||||
| Address2: | SUITE D | ||||||||
| City: | BLAIRSVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305127830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067450091 | ||||||||
| FaxNumber: | 7067450099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2011 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | HADS00836 | GA | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.