Provider Demographics
NPI:1720362957
Name:MILLER-HOSSEINI, HANNAH ASHLEY (SLP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ASHLEY
Last Name:MILLER-HOSSEINI
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 1:8674 OLYMPIA DR
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010-9540
Mailing Address - Country:US
Mailing Address - Phone:815-703-0629
Mailing Address - Fax:
Practice Address - Street 1:209 9TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2235
Practice Address - Country:US
Practice Address - Phone:815-489-4470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.002037235Z00000X
IL146011289235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist