Provider Demographics
NPI:1679219158
Name:GROSS, HANNAH CAILIN (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:CAILIN
Last Name:GROSS
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 MONROE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-2460
Mailing Address - Country:US
Mailing Address - Phone:704-847-3911
Mailing Address - Fax:
Practice Address - Street 1:9111 MONROE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-2460
Practice Address - Country:US
Practice Address - Phone:704-847-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist