Provider Demographics
NPI:1376192187
Name:HATTIER, JOHANNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:HATTIER
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 1:31 HOSIER ST
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-9300
Mailing Address - Country:US
Mailing Address - Phone:302-436-1000
Mailing Address - Fax:
Practice Address - Street 1:31 HOSIER ST
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-9300
Practice Address - Country:US
Practice Address - Phone:302-436-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist