1164668521 NPI number — DR. MINDY ERIN PARDOLL MINDY PARDOLL

Table of content: MRS. ASHLEIGH LYNNE BOWER CCC-SLP (NPI 1356970818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164668521 NPI number — DR. MINDY ERIN PARDOLL MINDY PARDOLL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARDOLL
Provider First Name:
MINDY
Provider Middle Name:
ERIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MINDY PARDOLL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PARDOLL
Provider Other First Name:
MINDY
Provider Other Middle Name:
ERIN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MINDY PARDOLL
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1164668521
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 S LEXINGTON AVE UNIT 307
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28801-3323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-519-7455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 S LEXINGTON AVE UNIT 307
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-3323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-519-7455
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  3687 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)