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General NPI Number Information
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NPI Number | 1396996849
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Entity Type | Individual
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Provider Name | PATRICIA HACKETT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 13707 DALLAS DR
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City | HUDSON
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State | FL
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Zip | 34667-7179
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Country | US
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Telephone | 727-378-5823
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Fax | 727-378-5824
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Provider Business Mailing Address
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Address Line | 13707 DALLAS DR
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City | HUDSON
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State | FL
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Zip | 34667-7179
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Country | US
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Telephone | 727-378-5823
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Fax | 727-378-5824
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.010082
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA11165
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License Number State | FL
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