Provider Demographics
NPI:1508096868
Name:HAIDER, DONNA MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:HAIDER
Suffix:
Gender:F
Credentials:AUD
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 43815
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-0815
Mailing Address - Country:US
Mailing Address - Phone:763-493-3988
Mailing Address - Fax:
Practice Address - Street 1:215 HIGHWAY 55 E
Practice Address - Street 2:SUITE 103
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-8905
Practice Address - Country:US
Practice Address - Phone:763-684-4887
Practice Address - Fax:763-684-4899
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5941237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter