Healthcare Provider Details

I. General information

NPI: 1366361693
Provider Name (Legal Business Name): HANNAH PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH LEA HERTZENBERG

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E LAS PALMARITAS DR
PHOENIX AZ
85020-3850
US

IV. Provider business mailing address

1314 E LAS PALMARITAS DR
PHOENIX AZ
85020-3850
US

V. Phone/Fax

Practice location:
  • Phone: 480-318-5076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA14571
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: