Provider Demographics
NPI:1962650309
Name:HAUSZ, ANDREA K (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:K
Last Name:HAUSZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7928 PEKIN RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47124-9607
Mailing Address - Country:US
Mailing Address - Phone:812-923-7683
Mailing Address - Fax:812-923-7683
Practice Address - Street 1:7928 PEKIN RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IN
Practice Address - Zip Code:47124-9607
Practice Address - Country:US
Practice Address - Phone:812-923-7683
Practice Address - Fax:812-923-7683
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003382A235Z00000X
KYKY-2213235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist