Provider Demographics
NPI:1104486141
Name:HAAS, SADIE LYN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:LYN
Last Name:HAAS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 BARONNE ST APT C
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-1576
Mailing Address - Country:US
Mailing Address - Phone:504-701-2414
Mailing Address - Fax:
Practice Address - Street 1:2016 BARONNE ST APT C
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1576
Practice Address - Country:US
Practice Address - Phone:504-701-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist