Provider Demographics
NPI:1396360020
Name:MARTIN, HANNAH ELISE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELISE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 SUNDANCE CIR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-1657
Mailing Address - Country:US
Mailing Address - Phone:704-880-9011
Mailing Address - Fax:
Practice Address - Street 1:1016 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-9472
Practice Address - Country:US
Practice Address - Phone:336-667-9261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2103013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist