Provider Demographics
NPI:1265606891
Name:RISKI, MAUREEN CASSIDY (AUD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CASSIDY
Last Name:RISKI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:3333 OLD MILTON PKWY STE 520
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4626
Practice Address - Country:US
Practice Address - Phone:770-777-1100
Practice Address - Fax:770-751-9089
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003173231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist