Healthcare Provider Details

I. General information

NPI: 1407004906
Provider Name (Legal Business Name): JUDITH HIRSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDITH HIRSCH M.A., CCC-A

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS STE 308
ST THOMAS VI
00802-3132
US

IV. Provider business mailing address

572 SEGOVIA RD
ST AUGUSTINE FL
32086-6454
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-8881
  • Fax: 340-776-9807
Mailing address:
  • Phone: 340-513-1926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: