Healthcare Provider Details

I. General information

NPI: 1225945934
Provider Name (Legal Business Name): HADLEE ANN HOGAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 LOVE AVE
TIFTON GA
31794-4403
US

IV. Provider business mailing address

144 WENDY LN
FITZGERALD GA
31750-8679
US

V. Phone/Fax

Practice location:
  • Phone: 229-402-7188
  • Fax: 229-472-8169
Mailing address:
  • Phone: 229-425-6099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP014153
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: