Provider Demographics
NPI:1972568178
Name:WEINBERG, JUDY (ACA)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:ACA
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACA
Mailing Address - Street 1:4106 W HATCHER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3247
Mailing Address - Country:US
Mailing Address - Phone:602-714-3545
Mailing Address - Fax:623-937-0395
Practice Address - Street 1:1512 W BELL RD
Practice Address - Street 2:#5
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-3466
Practice Address - Country:US
Practice Address - Phone:602-866-7082
Practice Address - Fax:623-937-0395
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ322237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist