Basic Information
| Provider Information | |||||||||
| NPI: | 1790746568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAGGART | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LINK | ||||||||
| OtherFirstName: | DAWN | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 545 | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163460545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146776381 | ||||||||
| FaxNumber: | 8146776384 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 PARK WAY | ||||||||
| Address2: | |||||||||
| City: | SENECA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 163462413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146776381 | ||||||||
| FaxNumber: | 8146776384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | X | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AT001170L | PA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.