Provider Demographics
NPI:1952962201
Name:REEG, HANNAH BARCLAY (AUD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BARCLAY
Last Name:REEG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 RENAISSANCE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2180
Mailing Address - Country:US
Mailing Address - Phone:269-982-3444
Mailing Address - Fax:
Practice Address - Street 1:511 RENAISSANCE DR STE 100
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2180
Practice Address - Country:US
Practice Address - Phone:269-982-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000841231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist