Provider Demographics
NPI:1578187498
Name:LOGAN, HANNAH MARIE (MA ED SLP-CF)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:LOGAN
Suffix:
Gender:F
Credentials:MA ED SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 CLOVER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2611
Mailing Address - Country:US
Mailing Address - Phone:606-344-2701
Mailing Address - Fax:
Practice Address - Street 1:181 OLD WHITLEY RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-8211
Practice Address - Country:US
Practice Address - Phone:606-330-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist