Provider Demographics
NPI:1639857907
Name:HANNAH, CHARLTON ABIGAIL (AUD)
Entity Type:Individual
Prefix:
First Name:CHARLTON
Middle Name:ABIGAIL
Last Name:HANNAH
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 1:1235 CERNAN DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-3109
Mailing Address - Country:US
Mailing Address - Phone:423-834-2248
Mailing Address - Fax:
Practice Address - Street 1:120 GOVERNORS DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4336
Practice Address - Country:US
Practice Address - Phone:256-265-7952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1336A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist