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Speech, Language and Hearing Service Providers Audiologist

Provider NPI: 1699183590

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 815-762-5984  Fax: --

Business Mailing Address:
Tel: 815-762-5984  Fax: --

NPI Information:
NPI: 1699183590
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y231H00000XSpeech, Language and Hearing Service Providers
N231HA2400XSpeech, Language and Hearing Service Providers
N231HA2500XSpeech, Language and Hearing Service Providers
N237600000XSpeech, Language and Hearing Service Providers
Audiologist-Hearing Aid Fitter

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 231H00000X





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