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General NPI Number Information
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NPI Number | 1578122792
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Entity Type | Individual
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Provider Name | KRISTEN HAHN FANNING SLP
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Gender | Female
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 28604 INTERSTATE 10 W UNIT 8
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City | BOERNE
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State | TX
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Zip | 78006-9115
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Country | US
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Telephone | 830-755-8853
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Fax | 830-755-8875
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Provider Business Mailing Address
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Address Line | 29825 WINDCHIME HL
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City | FAIR OAKS RANCH
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State | TX
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Zip | 78015-4589
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Country | US
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Telephone | 817-456-8039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 115417
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License Number State | TX
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