Healthcare Provider Details

I. General information

NPI: 1699466508
Provider Name (Legal Business Name): HANNAH ROSE HOUSER MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E 19TH ST
DUMAS TX
79029-5657
US

IV. Provider business mailing address

3615 S RUSK ST
AMARILLO TX
79109-4833
US

V. Phone/Fax

Practice location:
  • Phone: 806-935-4143
  • Fax:
Mailing address:
  • Phone: 806-678-0439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number119564
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: