Provider Demographics
NPI:1891407813
Name:HANNA, KRISTEN LEE (BA, SLP-A)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LEE
Last Name:HANNA
Suffix:
Gender:F
Credentials:BA, SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710B RICHLAND ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2636
Mailing Address - Country:US
Mailing Address - Phone:803-253-6223
Mailing Address - Fax:
Practice Address - Street 1:1710B RICHLAND ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2636
Practice Address - Country:US
Practice Address - Phone:803-253-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82612355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant