Basic Information
Provider Information
NPI: 1558357582
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RHOADES
FirstName: JULIE
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: AU.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3 QUARRY RD
Address2:  
City: HALIFAX
State: PA
PostalCode: 170329759
CountryCode: US
TelephoneNumber: 7173620904
FaxNumber:  
Practice Location
Address1: 500 UNIVERSITY DR
Address2: UPC I, SUITE 700, MC HU10
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 7175317171
FaxNumber: 7175310919
Other Information
ProviderEnumerationDate: 09/26/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAT-001074-LPAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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