Provider Demographics
NPI:1235881012
Name:HASE, HEATHER DAWN
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:HASE
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 1:311 NE 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:ND
Mailing Address - Zip Code:58552-7519
Mailing Address - Country:US
Mailing Address - Phone:701-693-6480
Mailing Address - Fax:
Practice Address - Street 1:311 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:ND
Practice Address - Zip Code:58552-7519
Practice Address - Country:US
Practice Address - Phone:701-693-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty