MEDICARE: NATALIE HANCOCK MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SLPA10247	AZ
2	235Z00000X	Speech-Language Pathologist	SLP10247	AZ

General Provider Information

NPI Number	:	1083156210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE HANCOCK MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3514 SUNRISE ST
Second Line	:
City	:	WINSLOW
State	:	AZ
Zip	:	86047-7901
Country	:	US
Telephone Number	:	602-400-6287
Fax Number	:

Provider Business Practice Location Address
First Line	:	8176 WESTOVER ST
Second Line	:
City	:	JOSEPH CITY
State	:	AZ
Zip	:	86032-2500
Country	:	US
Telephone Number	:	928-288-3307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2016
Last Update Date	:	04/25/2023

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