Provider Demographics
NPI:1265686885
Name:HALL CHACCHIA, TRICIA ANN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANN
Last Name:HALL CHACCHIA
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 1:2 CHARLES BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:CROTON-ON-HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-3406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 CHARLES BRIGGS RD
Practice Address - Street 2:
Practice Address - City:CROTON-ON-HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-3406
Practice Address - Country:US
Practice Address - Phone:914-862-0424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016447235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY016447OtherNY STATE LICENSE