Provider Demographics
NPI:1649712290
Name:SAUL, IVY MICHELLE (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:IVY
Middle Name:MICHELLE
Last Name:SAUL
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 CARMEL COMMONS BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226
Mailing Address - Country:US
Mailing Address - Phone:704-412-7975
Mailing Address - Fax:888-965-9948
Practice Address - Street 1:11121 CARMEL COMMONS BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226
Practice Address - Country:US
Practice Address - Phone:704-412-7975
Practice Address - Fax:888-965-9948
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4112231H00000X
NC1707034231H00000X
NC12634231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist