Provider Demographics
NPI:1437986825
Name:HAGERAENG, MARIA BEATRICE (SLPA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:BEATRICE
Last Name:HAGERAENG
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-3834
Mailing Address - Country:US
Mailing Address - Phone:415-521-4028
Mailing Address - Fax:
Practice Address - Street 1:113 CUMBERLAND AVE STE 110
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3339
Practice Address - Country:US
Practice Address - Phone:615-596-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN802235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist