Provider Demographics
NPI:1508391004
Name:NICOLAS, HANNAH MARIE (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:NICOLAS
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 CREEKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1254
Mailing Address - Country:US
Mailing Address - Phone:267-566-6546
Mailing Address - Fax:
Practice Address - Street 1:1009 CREEKVIEW DR
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1254
Practice Address - Country:US
Practice Address - Phone:267-566-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-22
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist