Provider Demographics
NPI:1134150436
Name:CREUZ, JUDITH ANN (AUD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:CREUZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:HANNOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:811 WEBSTER DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4223
Mailing Address - Country:US
Mailing Address - Phone:814-235-1708
Mailing Address - Fax:
Practice Address - Street 1:110 FORD BUILDING
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-5633
Practice Address - Country:US
Practice Address - Phone:814-865-5414
Practice Address - Fax:814-863-3759
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-00513-L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist