Provider Demographics
NPI:1578289617
Name:HANNAH, COREY (SLP)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:
Last Name:HANNAH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W LAYTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-3692
Mailing Address - Country:US
Mailing Address - Phone:833-577-3422
Mailing Address - Fax:801-397-8709
Practice Address - Street 1:201 W LAYTON PKWY
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-3692
Practice Address - Country:US
Practice Address - Phone:833-577-3422
Practice Address - Fax:801-397-8709
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14358938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist