Provider Demographics
NPI:1376978874
Name:BOHN, AMANDA E (AUD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:BOHN
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 1:400 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-2032
Mailing Address - Country:US
Mailing Address - Phone:507-508-6951
Mailing Address - Fax:507-512-1372
Practice Address - Street 1:400 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082-2032
Practice Address - Country:US
Practice Address - Phone:507-508-6951
Practice Address - Fax:507-512-1372
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA851231H00000X
MN9791231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter