Provider Demographics
NPI:1730104068
Name:KRUEGER, JANET (MA)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 S LAMAR BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-3373
Mailing Address - Country:US
Mailing Address - Phone:512-704-7447
Mailing Address - Fax:512-519-4385
Practice Address - Street 1:2003 S LAMAR BLVD STE 4
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-3373
Practice Address - Country:US
Practice Address - Phone:512-704-7447
Practice Address - Fax:512-519-4385
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50813231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist