Healthcare Provider Details

I. General information

NPI: 1598800534
Provider Name (Legal Business Name): EMILY E HASSELBECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 TIMBER TRAIL DR
MIDDLETOWN OH
45044-5349
US

IV. Provider business mailing address

8332 LANDMARK CT #206
WEST CHESTER OH
45069-8829
US

V. Phone/Fax

Practice location:
  • Phone: 513-423-9496
  • Fax: 513-727-3806
Mailing address:
  • Phone: 513-423-9496
  • Fax: 513-727-3806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP8216
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: