Provider Demographics
NPI:1487799557
Name:BOLL, MARY E (AUD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:BOLL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:10174 E CANYON MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-5505
Mailing Address - Country:US
Mailing Address - Phone:520-296-2894
Mailing Address - Fax:
Practice Address - Street 1:6567 E CARONDELET DR STE 515
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6158
Practice Address - Country:US
Practice Address - Phone:520-296-8500
Practice Address - Fax:520-733-2389
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1754237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter