Provider Demographics
NPI:1104564756
Name:HAIDARY, SABAAH (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SABAAH
Middle Name:
Last Name:HAIDARY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ENTRADA PLZ
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3746
Mailing Address - Country:US
Mailing Address - Phone:510-789-5612
Mailing Address - Fax:
Practice Address - Street 1:37490 BIRCH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-4140
Practice Address - Country:US
Practice Address - Phone:510-818-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist