Provider Demographics
NPI:1033604566
Name:HALBERSTADT, CLAIRE MARIE
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:HALBERSTADT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MARLKRESS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2334
Mailing Address - Country:US
Mailing Address - Phone:856-424-5552
Mailing Address - Fax:856-424-5559
Practice Address - Street 1:1111 MARLKRESS RD STE 103
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2334
Practice Address - Country:US
Practice Address - Phone:856-424-5552
Practice Address - Fax:856-424-5559
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-304235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist