Provider Demographics
NPI:1861721573
Name:SEIDL, ELIZABETH (AUD, CCC-A)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:SEIDL
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 1:9250 N 3RD ST
Mailing Address - Street 2:SUITE 3025
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2437
Mailing Address - Country:US
Mailing Address - Phone:602-678-5001
Mailing Address - Fax:602-678-4787
Practice Address - Street 1:9250 N 3RD ST
Practice Address - Street 2:SUITE 3025
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2437
Practice Address - Country:US
Practice Address - Phone:602-678-5001
Practice Address - Fax:602-678-4787
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter