Provider Demographics
NPI:1306121934
Name:ALDOUS, JESSE DEAN (HAD)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:DEAN
Last Name:ALDOUS
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 S PROGRESS AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-4822
Mailing Address - Country:US
Mailing Address - Phone:208-888-0387
Mailing Address - Fax:
Practice Address - Street 1:750 S PROGRESS AVE STE 105
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-4822
Practice Address - Country:US
Practice Address - Phone:208-888-0387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist