Provider Demographics
NPI:1265196034
Name:HASFJORD, HEIDI ANNETTE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:ANNETTE
Last Name:HASFJORD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DONLEY DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-2102
Mailing Address - Country:US
Mailing Address - Phone:817-399-3920
Mailing Address - Fax:
Practice Address - Street 1:1600 DONLEY DR
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-2102
Practice Address - Country:US
Practice Address - Phone:817-399-3920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13381235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist