Provider Demographics
NPI:1710489851
Name:HINTGEN, JULIE JO (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JO
Last Name:HINTGEN
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5034
Mailing Address - Country:US
Mailing Address - Phone:605-394-1813
Mailing Address - Fax:605-394-6766
Practice Address - Street 1:21 SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2822
Practice Address - Country:US
Practice Address - Phone:605-394-1813
Practice Address - Fax:605-394-6766
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD32231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist