Provider Demographics
NPI:1821658659
Name:THORNE, JULIE ANN (AUD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:THORNE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:HOLTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1465 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1003
Mailing Address - Country:US
Mailing Address - Phone:314-577-5671
Mailing Address - Fax:314-577-5383
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-577-5671
Practice Address - Fax:314-577-5383
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019017992237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter