Provider Demographics
NPI:1790403749
Name:SPIVEY, HANNAH (SLP-CF, TSSLD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:SLP-CF, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 MAYFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-6109
Mailing Address - Country:US
Mailing Address - Phone:615-948-9687
Mailing Address - Fax:
Practice Address - Street 1:450 SAINT PAULS PL FL 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-1938
Practice Address - Country:US
Practice Address - Phone:347-286-7965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1632379221390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty