Provider Demographics
NPI:1801220314
Name:HOEFLER, JESSICA STACY (AUD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:STACY
Last Name:HOEFLER
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 1:126 YORK AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5615
Mailing Address - Country:US
Mailing Address - Phone:330-726-3339
Mailing Address - Fax:330-726-0482
Practice Address - Street 1:126 YORK AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5615
Practice Address - Country:US
Practice Address - Phone:330-726-3339
Practice Address - Fax:330-726-0482
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01871231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist