Provider Demographics
NPI:1376687350
Name:HAYDEN, ELIZABETH ANN (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3354
Mailing Address - Country:US
Mailing Address - Phone:908-684-0162
Mailing Address - Fax:973-940-8918
Practice Address - Street 1:102 ROCK RD
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3354
Practice Address - Country:US
Practice Address - Phone:908-684-0162
Practice Address - Fax:973-940-8918
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00026500237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MG00058300OtherHEARING AID DISPENSER LIC
NJ41YA00026500OtherAUDIOLOGY LICENSE