Provider Demographics
NPI:1760604201
Name:UPDIKE, CLAUDIA DIANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:DIANE
Last Name:UPDIKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 W CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-1407
Mailing Address - Country:US
Mailing Address - Phone:765-288-6767
Mailing Address - Fax:
Practice Address - Street 1:BALL STATE UNIVERSITY AUDIOLOGY CLINIC
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-0001
Practice Address - Country:US
Practice Address - Phone:765-285-8172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN001675231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist