Basic Information
| Provider Information | |||||||||
| NPI: | 1134780679 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEWALD | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 44 ONTEORA BLVD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288031151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9127130499 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288052576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282987911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2019 | ||||||||
| LastUpdateDate: | 06/25/2019 | ||||||||
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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 | 231H00000X | 13669 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.