| Doctor Name: | KELLY AMANDA WYCOFF |
| NPI Number: | 1760812234 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | HIS |
| License Number: | 17001391A |
| Business Practice Address: | 359 S Landmark Ave Bloomington, IN - 474035002 |
| Business Phone Number: | 8123343919 |
| Business Fax Number: | 8123343936 |
| Mailing Address: | 215 Shuman Blvd, Ste 401 NAPERVILLE |
| State: | IL |
| Postal Code: | 605638123 |
| Phone Number: | 6303035380 |
| Fax Number: | 6303035385 |
| NPI Enumeration Date: | 11/20/2013 |
| NPI Last Update Date: | 01/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | 17001391A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |