Provider Demographics
NPI:1699246306
Name:DWEIDAR, HADIR (CCC-SLP)
Entity type:Individual
Prefix:
First Name:HADIR
Middle Name:
Last Name:DWEIDAR
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 1:1522 ORIEN LN
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-7418
Mailing Address - Country:US
Mailing Address - Phone:570-856-7713
Mailing Address - Fax:
Practice Address - Street 1:2071 ROUTE 209
Practice Address - Street 2:
Practice Address - City:BRODHEADSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18322-7754
Practice Address - Country:US
Practice Address - Phone:570-236-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist