Basic Information
| Provider Information | |||||||||
| NPI: | 1154753606 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HASSON | ||||||||
| FirstName: | HILARY | ||||||||
| MiddleName: | ROBIN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PINES | ||||||||
| OtherFirstName: | HILARY | ||||||||
| OtherMiddleName: | ROBIN | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.A. CCC-SLP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 14804 ENCLAVE LAKES DR | ||||||||
| Address2: | 19 T5 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613500538 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1239 E NEWPORT CENTER DR | ||||||||
| Address2: | 101 | ||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334427711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7544443707 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2013 | ||||||||
| LastUpdateDate: | 03/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA 13088 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | 009411700 | 05 | FL | MEDICAID |