Provider Demographics
NPI:1063662070
Name:HASSELL, KALEAH D (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KALEAH
Middle Name:D
Last Name:HASSELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 LEHMAN DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-1006
Mailing Address - Country:US
Mailing Address - Phone:614-834-2273
Mailing Address - Fax:
Practice Address - Street 1:36 LEHMAN DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-1006
Practice Address - Country:US
Practice Address - Phone:614-834-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist