Provider Demographics
NPI:1457572307
Name:HANNA, YVETTE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1865
Mailing Address - Country:US
Mailing Address - Phone:954-452-0420
Mailing Address - Fax:954-452-0420
Practice Address - Street 1:19200 MANATEE ISLES DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-2151
Practice Address - Country:US
Practice Address - Phone:754-323-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist