Full Name | |
---|---|
Type | Facility |
Speciality | Audiologist |
Location | 212 W 520 N, Orem, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225759210 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | (* (Not Available)) | Primary |
Provider Name | Brenda Devereaux |
---|---|
Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1245515980 PECOS PAC ID: 3173786852 Enrollment ID: I20120516000170 |
Mailing Address | Practice Location Address |
---|---|
5984 Park Meadow Dr, Morgan, UT 84050-6722 Ph: () - | 212 W 520 N, Orem, UT 84057-4695 Ph: (801) 221-1220 |
Andrea Lorraine Carbo, AUD Audiologist Medicare: Not Enrolled in Medicare Practice Location: 774 S State St, Orem, UT 84058 Phone: 801-235-0953 | |
Brenda Devereaux, MS CCC-A Audiologist Medicare: Medicare Enrolled Practice Location: 212 W 520 N, Orem, UT 84057 Phone: 801-221-1220 Fax: 801-515-0708 |