Provider Demographics
NPI:1174754287
Name:IMHAUSER, JUDY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:IMHAUSER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 QUAIL MEADOWS AVE
Mailing Address - Street 2:
Mailing Address - City:BETHEL HEIGHTS
Mailing Address - State:AR
Mailing Address - Zip Code:72764-8426
Mailing Address - Country:US
Mailing Address - Phone:660-473-9242
Mailing Address - Fax:
Practice Address - Street 1:1000 W STONE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5653
Practice Address - Country:US
Practice Address - Phone:479-444-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist