Provider Demographics
NPI:1578707378
Name:WARREN, HANNAH M (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:M
Last Name:WARREN
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:ARKANSAS
Mailing Address - Zip Code:72404
Mailing Address - Country:UM
Mailing Address - Phone:870-351-7867
Mailing Address - Fax:
Practice Address - Street 1:3524 OAKMONT DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9523
Practice Address - Country:US
Practice Address - Phone:870-351-7867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR175851721Medicaid