Provider Demographics
NPI:1851436216
Name:HADDEN, COLETTE (MA CCCA)
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:HADDEN
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 STONE AVE
Mailing Address - Street 2:HERRING SPECIALISTS PC
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106
Mailing Address - Country:US
Mailing Address - Phone:712-276-0050
Mailing Address - Fax:712-274-4393
Practice Address - Street 1:4509 STONE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106
Practice Address - Country:US
Practice Address - Phone:712-276-0050
Practice Address - Fax:712-276-0050
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00290231H00000X
NE150231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2047951Medicaid
IA2047951Medicaid