Individual
GRACE LIA HAQQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
1729 AUDUBON TRL, LUTZ, FL 33549-9511
(813) 385-4610
Mailing address
1729 AUDUBON TRL, LUTZ, FL 33549-9511
(813) 385-4610
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA16771
FL
Other
Enumeration date
05/29/2019
Last updated
07/10/2024
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