Provider Demographics
NPI:1518121722
Name:LARA, HYE CHIN (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:HYE CHIN
Middle Name:
Last Name:LARA
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:MR
Other - First Name:FERDINAND
Other - Middle Name:I
Other - Last Name:LARA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BC-HIS
Mailing Address - Street 1:1173 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6863
Mailing Address - Country:US
Mailing Address - Phone:803-796-2200
Mailing Address - Fax:803-796-0740
Practice Address - Street 1:1173 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-6863
Practice Address - Country:US
Practice Address - Phone:803-796-2200
Practice Address - Fax:803-796-0740
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC466237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist