Eliza Petersen, AUD, CCCA

NPI 1083750996 · on the registry since 2007 · sole proprietor

Practice

Address: 2740 Shadowmoon Ln Ste 417
Driggs, ID 83422
Phone: (307) 745-5587
Fax: (877) 515-1633

Registry record

Primary taxonomy: Audiologist
231H00000X
Also registered as: Audiologist
Licence states on file: WY, ID
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-04-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho