Provider Demographics
NPI:1194295287
Name:HASLINGER, CAMILLE REID (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:REID
Last Name:HASLINGER
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 1:2960 BEACH RD APT 1
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-2786
Mailing Address - Country:US
Mailing Address - Phone:616-485-9227
Mailing Address - Fax:
Practice Address - Street 1:1300 BEARD ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6562
Practice Address - Country:US
Practice Address - Phone:810-982-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14194836235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist