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NPI 1033143144

NPI 1033143144 : AMY IRENE HARTMAN M.A., CCC-A : WAUWATOSA, WI

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General NPI Number Information
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    NPI Number           |    1033143144
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    Entity Type          |    Individual 
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    Provider Name        |    AMY IRENE HARTMAN M.A., CCC-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    10310A W. WATERTOWN PLANK RD. 
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    City                 |    WAUWATOSA
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    State                |    WI
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    Zip                  |    53226
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    Country              |    US
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    Telephone            |    414-266-2919
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3225 S 83RD ST 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53219-3545
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    368-156
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    License Number State |    WI
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