Provider Demographics
NPI:1720648439
Name:GUHARAJAN, HANNAH JOY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:JOY
Last Name:GUHARAJAN
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 1:5665 JOHN F. KENNEDY BLVD
Mailing Address - Street 2:APT. 508
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047
Mailing Address - Country:US
Mailing Address - Phone:325-212-8892
Mailing Address - Fax:
Practice Address - Street 1:5665 JOHN F. KENNEDY BLVD
Practice Address - Street 2:APT. 508
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:325-212-8892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112861235Z00000X
NY027831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist