Provider Demographics
NPI:1063864437
Name:HANNA, STEPHANY FAYE (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:STEPHANY
Middle Name:FAYE
Last Name:HANNA
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 THURBERS AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4754
Mailing Address - Country:US
Mailing Address - Phone:401-453-7751
Mailing Address - Fax:
Practice Address - Street 1:134 THURBERS AVE STE 215
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-4754
Practice Address - Country:US
Practice Address - Phone:401-453-7751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00226231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist