Provider Demographics
NPI:1912031550
Name:WHITFIELD, HANNAH (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 MCDONOUGH RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-1524
Mailing Address - Country:US
Mailing Address - Phone:770-775-7861
Mailing Address - Fax:770-775-2736
Practice Address - Street 1:1050 MCDONOUGH RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-1524
Practice Address - Country:US
Practice Address - Phone:770-775-7861
Practice Address - Fax:770-775-2736
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist