Provider Demographics
NPI:1184173999
Name:UTHUP, GIFTY E (AUD)
Entity type:Individual
Prefix:
First Name:GIFTY
Middle Name:E
Last Name:UTHUP
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:GIFTY
Other - Middle Name:T
Other - Last Name:EASOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-425-2646
Mailing Address - Fax:812-467-7209
Practice Address - Street 1:4015 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8925
Practice Address - Country:US
Practice Address - Phone:812-425-2646
Practice Address - Fax:812-467-7209
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002610A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist