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General NPI Number Information
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NPI Number | 1821245879
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Entity Type | Individual
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Provider Name | MS. CIINKHANMAAN HAUGO SUKTE
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Gender | Female
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 412 N WAYNE AVE 305
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City | WAYNE
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State | PA
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Zip | 19087-3248
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Country | US
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Telephone | 610-213-0734
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Fax | 610-995-2135
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Provider Business Mailing Address
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Address Line | 142 N. WAYNE AVE. 305
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City | WAYNE
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State | PA
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Zip | 19087
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Country | US
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Telephone | 610-213-0734
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Fax | 610-995-2135
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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 | SL007130
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License Number State | PA
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