Provider Demographics
NPI:1821371733
Name:HIERS, MICHELLE HANNA (MA, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:HANNA
Last Name:HIERS
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7596 BIDDIE LANE
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906
Mailing Address - Country:US
Mailing Address - Phone:843-846-4659
Mailing Address - Fax:
Practice Address - Street 1:10A MARSHELLEN DRIVE
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29935
Practice Address - Country:US
Practice Address - Phone:843-592-0936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2916235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5A0261Medicaid