Provider Demographics
NPI:1598816613
Name:HAZLETT, JOAN M (MA CCC A)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:HAZLETT
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 1:1065 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1801
Mailing Address - Country:US
Mailing Address - Phone:828-254-3517
Mailing Address - Fax:828-253-6960
Practice Address - Street 1:1065 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1801
Practice Address - Country:US
Practice Address - Phone:828-254-3517
Practice Address - Fax:828-253-6960
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13473237600000X, 237600000X
NC13474231H00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2095254Medicaid
OH0836941Medicare ID - Type Unspecified
OH2095254Medicaid