Provider Demographics
NPI:1417444175
Name:KITA, HAILEE HOEFER (HAS)
Entity Type:Individual
Prefix:
First Name:HAILEE
Middle Name:HOEFER
Last Name:KITA
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:HAILEE
Other - Middle Name:BREANNA
Other - Last Name:HOEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9875 JOHNNYCAKE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6748
Mailing Address - Country:US
Mailing Address - Phone:440-358-1559
Mailing Address - Fax:440-358-1567
Practice Address - Street 1:1438 SOM CENTER RD STE 101
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2111
Practice Address - Country:US
Practice Address - Phone:440-995-1000
Practice Address - Fax:440-995-1003
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHIL.03358237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist