Healthcare Provider Details

I. General information

NPI: 1548913916
Provider Name (Legal Business Name): HANNAH ELIZABETH HUFFMAN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 GREY BARK ST
ALEDO TX
76008-1708
US

IV. Provider business mailing address

1800 GREY BARK ST
ALEDO TX
76008-1708
US

V. Phone/Fax

Practice location:
  • Phone: 817-247-7735
  • Fax:
Mailing address:
  • Phone: 817-247-7735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number116955
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: