Provider Demographics
NPI:1629761630
Name:HACKETT, ADRIAN F (AUD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:F
Last Name:HACKETT
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 1:2454 MONROE ST STE A
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3038
Mailing Address - Country:US
Mailing Address - Phone:162-976-1630
Mailing Address - Fax:
Practice Address - Street 1:2454 MONROE ST STE A
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3038
Practice Address - Country:US
Practice Address - Phone:313-562-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601001115231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist