Provider Demographics
NPI:1255831004
Name:HAUGE, SHIRLEY JEAN (MA CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:HAUGE
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:PO BOX 218
Mailing Address - Street 2:2885 DICKSON DR
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-0218
Mailing Address - Country:US
Mailing Address - Phone:605-347-4467
Mailing Address - Fax:
Practice Address - Street 1:2885 DICKSON DR
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-0218
Practice Address - Country:US
Practice Address - Phone:605-347-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD001235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist