Provider Demographics
NPI:1447348792
Name:HADDAD, LAYTH (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAYTH
Middle Name:
Last Name:HADDAD
Suffix:
Gender:M
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 COTTAGE GROVE RD
Mailing Address - Street 2:SUITE E130
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3059
Mailing Address - Country:US
Mailing Address - Phone:860-286-0838
Mailing Address - Fax:860-286-0109
Practice Address - Street 1:701 COTTAGE GROVE RD
Practice Address - Street 2:SUITE E130
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3059
Practice Address - Country:US
Practice Address - Phone:860-286-0838
Practice Address - Fax:860-286-0109
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist