Provider Demographics
NPI:1700425527
Name:JEBARAJ, HAZEL PATRICIA
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:PATRICIA
Last Name:JEBARAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 SOUTHWESTERN BLVD APT 501
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-2811
Mailing Address - Country:US
Mailing Address - Phone:972-835-8335
Mailing Address - Fax:
Practice Address - Street 1:8100 LOMO ALTO DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6530
Practice Address - Country:US
Practice Address - Phone:214-368-8251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant