Provider Demographics
NPI:1134591332
Name:KUETTNER, HAILEY (MA, CF-SLP)
Entity type:Individual
Prefix:MS
First Name:HAILEY
Middle Name:
Last Name:KUETTNER
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 S 2ND ST
Mailing Address - Street 2:APT 3
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4703
Mailing Address - Country:US
Mailing Address - Phone:404-303-6444
Mailing Address - Fax:
Practice Address - Street 1:602 N SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1035
Practice Address - Country:US
Practice Address - Phone:253-571-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI 60581141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist