Provider Demographics
NPI:1831553882
Name:BACAOANU, AMELIA (AUD)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:BACAOANU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:
Other - Last Name:HIBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4835 KIETZKE LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6549
Mailing Address - Country:US
Mailing Address - Phone:775-343-7680
Mailing Address - Fax:
Practice Address - Street 1:4835 KIETZKE LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6549
Practice Address - Country:US
Practice Address - Phone:775-343-7680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1826 DISPENSING231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist