Basic Information
Provider Information
NPI: 1962668996
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAIME
FirstName: CLAUDIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CCC-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 888 WORCESTER ST
Address2: SUITE 130
City: WELLESLEY
State: MA
PostalCode: 024823744
CountryCode: US
TelephoneNumber: 6179646681
FaxNumber: 3396862561
Practice Location
Address1: 888 WORCESTER ST
Address2: SUITE 130
City: WELLESLEY
State: MA
PostalCode: 024823744
CountryCode: US
TelephoneNumber: 6179646681
FaxNumber: 3396862561
Other Information
ProviderEnumerationDate: 07/30/2008
LastUpdateDate: 03/15/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XA438NHY Speech, Language and Hearing Service ProvidersAudiologist 
231H00000X498MAN Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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