Provider Demographics
NPI:1396976536
Name:AUDIOLOGY CLINIC OF NORTHWEST OHIO, LTD.
Entity type:Organization
Organization Name:AUDIOLOGY CLINIC OF NORTHWEST OHIO, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SONNENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:419-969-0865
Mailing Address - Street 1:1411 N SCOTT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-1025
Mailing Address - Country:US
Mailing Address - Phone:419-592-0338
Mailing Address - Fax:
Practice Address - Street 1:1411 N SCOTT ST
Practice Address - Street 2:SUITE B
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-1025
Practice Address - Country:US
Practice Address - Phone:419-592-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-01161261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center