Provider Demographics
NPI:1083156210
Name:HANCOCK, NATALIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 SUNRISE ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:AZ
Mailing Address - Zip Code:86047-7901
Mailing Address - Country:US
Mailing Address - Phone:602-400-6287
Mailing Address - Fax:
Practice Address - Street 1:8176 WESTOVER ST
Practice Address - Street 2:
Practice Address - City:JOSEPH CITY
Practice Address - State:AZ
Practice Address - Zip Code:86032-2500
Practice Address - Country:US
Practice Address - Phone:928-288-3307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA102472355S0801X
AZSLP10247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant