Individual
ANDREA T ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
834 N SEMINARY ST, GALESBURG, IL 61401-2852
(309) 343-1632
(309) 343-1785
Mailing address
834 N SEMINARY ST, SUITE 405, GALESBURG, IL 61401-2852
(309) 343-1632
(309) 343-1785
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
00597
IA
231H00000X
Audiologist
Primary
147.001190
IL
237600000X
Audiologist-Hearing Aid Fitter
00890
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740361484
—
IA
Enumeration date
10/18/2006
Last updated
09/12/2022
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