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General NPI Number Information
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NPI Number | 1033581087
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Entity Type | Organization
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Legal Business Name | HOPEWELL AUDIOLOGY, LLC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 393 DUNLAP ST N SUITE 115
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City | SAINT PAUL
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State | MN
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Zip | 55104-4200
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Country | US
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Telephone | 651-646-2427
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Fax |
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Provider Business Mailing Address
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Address Line | 3951 WASHBURN AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55412-1824
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Country | US
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Telephone | 612-868-3461
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. REBECCA YOUNK
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Credential | AU.D.
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Telephone | 612-868-3461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 7525
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 7525
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License Number State | MN
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