Provider Demographics
NPI:1871991661
Name:BARTOLDUS, THERESA (AUD)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:
Last Name:BARTOLDUS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 UNIVERSITY LAKE DR
Mailing Address - Street 2:AUDIOLOGY DEPARTMENT
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4658
Mailing Address - Country:US
Mailing Address - Phone:907-729-1400
Mailing Address - Fax:
Practice Address - Street 1:3801 UNIVERSITY LAKE DR
Practice Address - Street 2:SOUTHCENTRAL FOUNDATION AUDIOLOGY DEPARTMENT
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4658
Practice Address - Country:US
Practice Address - Phone:907-729-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK144231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist