Provider Demographics
NPI:1659408177
Name:NEUENDORF, RENATE DOROTHEA (AUD)
Entity Type:Individual
Prefix:DR
First Name:RENATE
Middle Name:DOROTHEA
Last Name:NEUENDORF
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:DOROTHEA
Other - Middle Name:RENATE
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:CMR 415
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09114
Mailing Address - Country:US
Mailing Address - Phone:314-590-3205
Mailing Address - Fax:
Practice Address - Street 1:UNIT 28130, BLDG 475, RM 330
Practice Address - Street 2:
Practice Address - City:GRAFENWOEHR
Practice Address - State:BAVARIA
Practice Address - Zip Code:92655
Practice Address - Country:DE
Practice Address - Phone:314-590-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22046231HA2400X, 231HA2500X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter