Provider Demographics
NPI:1578900064
Name:HOERTH, ASHLEY J (AUD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:HOERTH
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 1:1442 N 31ST ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3061
Mailing Address - Country:US
Mailing Address - Phone:920-458-3277
Mailing Address - Fax:920-458-5255
Practice Address - Street 1:1442 N 31ST ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3061
Practice Address - Country:US
Practice Address - Phone:920-458-3277
Practice Address - Fax:920-458-5255
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
WI582-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist