Provider Demographics
NPI:1598400897
Name:ECKDAHL, HANNAH (AUD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:ECKDAHL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 CLYDE MORRIS BLVD STE C1
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8204
Mailing Address - Country:US
Mailing Address - Phone:386-677-2366
Mailing Address - Fax:
Practice Address - Street 1:290 CLYDE MORRIS BLVD STE C1
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8204
Practice Address - Country:US
Practice Address - Phone:386-677-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist