MEDICARE: COLETTE HADDEN MA CCCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	00290	IA
2	231H00000X	Audiologist	150	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851436216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLETTE HADDEN MA CCCA

Provider Business Mailing Address
First Line	:	4509 STONE AVE
Second Line	:	HERRING SPECIALISTS PC
City	:	SIOUX CITY
State	:	IA
Zip	:	51106
Country	:	US
Telephone Number	:	712-276-0050
Fax Number	:	712-274-4393

Provider Business Practice Location Address
First Line	:	4509 STONE AVE
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106
Country	:	US
Telephone Number	:	712-276-0050
Fax Number	:	712-276-0050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/08/2007

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Directions to “ COLETTE HADDEN MA CCCA” Practice Location

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