Provider Demographics
NPI:1366549057
Name:KUHN, TIMOTHY M (AUD CCCA)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:KUHN
Suffix:
Gender:M
Credentials:AUD CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 SCHOFIELD AVE. STE. 106
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-9998
Mailing Address - Country:US
Mailing Address - Phone:715-298-5511
Mailing Address - Fax:715-298-5510
Practice Address - Street 1:1699 SCHOFIELD AVE. STE. 106
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-9998
Practice Address - Country:US
Practice Address - Phone:715-298-5511
Practice Address - Fax:715-298-5510
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI273231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41131700Medicaid
WI41131700Medicaid
WI007839295Medicare ID - Type Unspecified