Provider Demographics
NPI:1134738842
Name:MASSA, HANNAH SOPHER (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:SOPHER
Last Name:MASSA
Suffix:
Gender:
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 1:1819 W WAHALLA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4229
Mailing Address - Country:US
Mailing Address - Phone:410-404-2867
Mailing Address - Fax:
Practice Address - Street 1:11201 N TATUM BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6037
Practice Address - Country:US
Practice Address - Phone:623-263-3966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP12527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist