Healthcare Provider Details

I. General information

NPI: 1700370160
Provider Name (Legal Business Name): HANNAH CLOUSE M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 BILLINGSLEY RD
COLUMBUS OH
43235-1990
US

IV. Provider business mailing address

526 ELBRIDGE ST
DELAWARE OH
43015-7548
US

V. Phone/Fax

Practice location:
  • Phone: 614-470-2018
  • Fax:
Mailing address:
  • Phone: 614-571-0184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: