Provider Demographics
NPI:1205097730
Name:HAGGE, TRISHA CHRISTINE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:CHRISTINE
Last Name:HAGGE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:CHRISTINE
Other - Last Name:NOBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1521 ASHWICKEN CT N
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4374
Mailing Address - Country:US
Mailing Address - Phone:501-920-9711
Mailing Address - Fax:
Practice Address - Street 1:1521 ASHWICKEN CT N
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4374
Practice Address - Country:US
Practice Address - Phone:501-920-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist