Provider Demographics
NPI:1902386964
Name:WALKER, HANNAH BROOKE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BROOKE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1046
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401-1046
Mailing Address - Country:US
Mailing Address - Phone:575-640-4369
Mailing Address - Fax:
Practice Address - Street 1:1701 S 11TH ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-3715
Practice Address - Country:US
Practice Address - Phone:575-461-4344
Practice Address - Fax:575-461-8033
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLP6030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist