Kitara Hazen
Speech-Language Pathologist, in San Antonio, TX. Individual provider (NPI-1).
NPI number1417491069
StatusActive
Last updated in NPPESDec 15, 2016
Details
- NPI
- 1417491069
- Entity type
- Individual (NPI-1)
- Name
- Kitara Hazen
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 15, 2016
- Last updated
- Dec 15, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 111346 | TX | Yes |
Practice location
16201 Rough Oak StApt 1231
San Antonio, TX 78232-1863
Phone 937-510-2700
Mailing address
16201 Rough Oak StApt 1231
San Antonio, TX 78232-1863
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