Healthcare Provider Details

I. General information

NPI: 1245969666
Provider Name (Legal Business Name): MONICA HASSETT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 STALLSVILLE LOOP
SUMMER SHADE SC
29485-4934
US

IV. Provider business mailing address

221 STALLSVILLE ROAD
SUMMER SHADE SC
29485-4934
US

V. Phone/Fax

Practice location:
  • Phone: 843-832-1795
  • Fax: 843-832-9499
Mailing address:
  • Phone: 843-832-1795
  • Fax: 843-832-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: