Provider Demographics
NPI:1962872507
Name:RABELHOFER, JULIETTE
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:
Last Name:RABELHOFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S MONROE AVE
Mailing Address - Street 2:APT 3L
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-4000
Mailing Address - Country:US
Mailing Address - Phone:206-327-1676
Mailing Address - Fax:
Practice Address - Street 1:425 S MONROE AVE
Practice Address - Street 2:APT 3L
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4000
Practice Address - Country:US
Practice Address - Phone:206-327-1676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4032-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist