Provider Demographics
NPI:1003425067
Name:BRAGG, HANNAH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BRAGG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:CASSIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 W COLORADO CT
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-8186
Mailing Address - Country:US
Mailing Address - Phone:503-351-3217
Mailing Address - Fax:
Practice Address - Street 1:1857 S MILLENIUM WAY STE 120
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1510
Practice Address - Country:US
Practice Address - Phone:208-600-0722
Practice Address - Fax:208-620-2134
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist