Provider Demographics
NPI:1578041539
Name:VANHOOSE, MARIAH (AUD)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:VANHOOSE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:
Other - Last Name:RICHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:101 S BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3749
Mailing Address - Country:US
Mailing Address - Phone:660-665-9114
Mailing Address - Fax:573-756-0505
Practice Address - Street 1:101 S BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3749
Practice Address - Country:US
Practice Address - Phone:660-665-9114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018028143231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist