Provider Demographics
NPI:1821660200
Name:GUITH, MADILYN NICOLE (AUD)
Entity Type:Individual
Prefix:
First Name:MADILYN
Middle Name:NICOLE
Last Name:GUITH
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 1:5565 BLAINE AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1239
Mailing Address - Country:US
Mailing Address - Phone:651-888-7800
Mailing Address - Fax:
Practice Address - Street 1:5565 BLAINE AVE STE 225
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1239
Practice Address - Country:US
Practice Address - Phone:651-888-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN518150231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist