Basic Information
| Provider Information | |||||||||
| NPI: | 1043584873 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HASSON | ||||||||
| FirstName: | ADI | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3530 HELMS AVE | ||||||||
| Address2: | |||||||||
| City: | CULVER CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902322415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9499394412 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 W 6TH ST | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900171800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2136074400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2012 | ||||||||
| LastUpdateDate: | 07/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 6977 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.