Individual
BENJAMIN DON HAZLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
898 SW 4TH AVE, ONTARIO, OR 97914-2627
(541) 881-7330
Mailing address
1120 S MUSCOVY AVE, MERIDIAN, ID 83642-7748
(208) 954-9427
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1932
ID
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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