Healthcare Provider Details

I. General information

NPI: 1073927141
Provider Name (Legal Business Name): HANNAH AUSTIN HALL CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CHARLOIS BLVD
WINSTON SALEM NC
27103-1508
US

IV. Provider business mailing address

210 CHARLOIS BLVD
WINSTON SALEM NC
27103-1508
US

V. Phone/Fax

Practice location:
  • Phone: 336-725-0222
  • Fax: 336-725-0454
Mailing address:
  • Phone: 336-725-0222
  • Fax: 336-725-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL016029
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5489
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30002076
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: