Provider Demographics
NPI:1346863115
Name:NEUHAUS, BAILEY (AUD)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:NEUHAUS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4122
Mailing Address - Country:US
Mailing Address - Phone:302-245-5588
Mailing Address - Fax:
Practice Address - Street 1:520 S EAGLE RD STE 1225
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-6355
Practice Address - Country:US
Practice Address - Phone:208-385-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID4305231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist