Provider Demographics
NPI:1679368930
Name:ROBERTS, HANNA J (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:J
Last Name:ROBERTS
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 1:2121 S COLUMBIA AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3513
Mailing Address - Country:US
Mailing Address - Phone:918-928-4700
Mailing Address - Fax:
Practice Address - Street 1:2121 S COLUMBIA AVE STE 501
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3513
Practice Address - Country:US
Practice Address - Phone:918-928-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist