| Mallory Faust, | |
|
141 Mack Bayou Loop Ste 202, Santa Rosa Beach, FL 32459-7194 | |
| (850) 622-0996 | |
| (850) 622-1185 |
| Full Name | Mallory Faust |
|---|---|
| Gender | Female |
| Speciality | Audiologist |
| Location | 141 Mack Bayou Loop Ste 202, Santa Rosa Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548600455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | AY1794 (Florida) | Primary |
| 237600000X | Audiologist-hearing Aid Fitter | AY1794 (Florida) | Secondary |
| Provider Name | Hearing Life Usa Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1366628166 PECOS PAC ID: 5698870426 Enrollment ID: O20090522000051 |
| Mailing Address | Practice Location Address |
|---|---|
| Mallory Faust, 141 Mack Bayou Loop Ste 202, Santa Rosa Beach, FL 32459-7194 Ph: (850) 622-0996 | Mallory Faust, 141 Mack Bayou Loop Ste 202, Santa Rosa Beach, FL 32459-7194 Ph: (850) 622-0996 |
Destin Hearing Associates Llc Audiologist Medicare: Medicare Enrolled Practice Location: 141 Mack Bayou Loop Ste 202, Santa Rosa Beach, FL 32459 Phone: 850-622-1185 | |
Amy Lynne Wusterbarth, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 141 Mack Bayou Loop Ste 202, Santa Rosa Beach, FL 32459 Phone: 850-622-0996 Fax: 850-622-1185 |