Provider Demographics
NPI:1053649236
Name:HAUSLADEN, JENNIFER U (AUD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:U
Last Name:HAUSLADEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7557 DANNAHER WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3558
Mailing Address - Country:US
Mailing Address - Phone:865-521-8050
Mailing Address - Fax:865-971-3509
Practice Address - Street 1:7557 DANNAHER WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3558
Practice Address - Country:US
Practice Address - Phone:865-521-8050
Practice Address - Fax:865-971-3509
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1275231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA023203Medicare PIN