1366775306 NPI number — JANE HADDAD

Table of content: (NPI 1366775306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366775306 NPI number — JANE HADDAD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JANE HADDAD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BEYOND WORDS SPEECH & LANGUAGE SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366775306
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 ISLAND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINTNERSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18930-9764
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-208-5048
Provider Business Mailing Address Fax Number:
610-847-2989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90803-3153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-439-6244
Provider Business Practice Location Address Fax Number:
562-438-6244
Provider Enumeration Date:
09/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
STUART
Authorized Official First Name:
JANE
Authorized Official Middle Name:
HADDAD
Authorized Official Title or Position:
SPECH PATHOLOGIST
Authorized Official Telephone Number:
562-439-6244

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SP9815 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com