Provider Demographics
NPI:1518745025
Name:HANSON, EMILY C (SLP-A)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:HANSON
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 S ESTRELLA CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6310
Mailing Address - Country:US
Mailing Address - Phone:602-576-8664
Mailing Address - Fax:
Practice Address - Street 1:3651 E BASELINE RD STE 203
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-5449
Practice Address - Country:US
Practice Address - Phone:602-315-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA142932355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant