Provider Demographics
NPI:1891882353
Name:CONLEY, JUDITH HERZ (MA)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:HERZ
Last Name:CONLEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:7810 BALLANTYNE COMMONS PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3416
Mailing Address - Country:US
Mailing Address - Phone:704-544-2274
Mailing Address - Fax:704-542-2285
Practice Address - Street 1:7810 BALLANTYNE COMMONS PKWY STE 210
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3416
Practice Address - Country:US
Practice Address - Phone:704-544-2274
Practice Address - Fax:704-542-2285
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2436231H00000X, 237700000X
CAHT8114237600000X
NC12108231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist