Provider Demographics
NPI:1508690579
Name:OLIVERAS, HANNAH GRACE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:GRACE
Last Name:OLIVERAS
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 1:120 GEORGES RD APT 312
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-4022
Mailing Address - Country:US
Mailing Address - Phone:908-399-7144
Mailing Address - Fax:
Practice Address - Street 1:579 CRANBURY RD STE I
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5405
Practice Address - Country:US
Practice Address - Phone:732-313-5458
Practice Address - Fax:732-955-6591
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01224600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist