Provider Demographics
NPI:1720135841
Name:HACHE, INGRID (OTR,L)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:HACHE
Suffix:
Gender:F
Credentials:OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2207
Mailing Address - Country:US
Mailing Address - Phone:781-828-5549
Mailing Address - Fax:
Practice Address - Street 1:450 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2207
Practice Address - Country:US
Practice Address - Phone:781-828-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9057174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist