Healthcare Provider Details

I. General information

NPI: 1831201417
Provider Name (Legal Business Name): JULIE K BARTH MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N. MAIN ST
HICKSVILLE OH
43526
US

IV. Provider business mailing address

119 N. MAIN ST
HICKSVILLE OH
43526
US

V. Phone/Fax

Practice location:
  • Phone: 419-542-8700
  • Fax: 419-542-8777
Mailing address:
  • Phone: 419-542-8700
  • Fax: 419-542-8777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23002018
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: