Healthcare Provider Details

I. General information

NPI: 1053932186
Provider Name (Legal Business Name): HANNAH KATHERINE CHAPMAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 S 8TH ST
GRIFFIN GA
30224-4884
US

IV. Provider business mailing address

71 E BROAD ST
NEWNAN GA
30263-2095
US

V. Phone/Fax

Practice location:
  • Phone: 770-229-6498
  • Fax:
Mailing address:
  • Phone: 678-633-8593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP011060
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPCET002922
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: