MEDICARE: JENNIFER HANSEN M.S., 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	235Z00000X	Speech-Language Pathologist	30001427	NC

General Provider Information

NPI Number	:	1093498909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HANSEN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	903 WOODHILL DR
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732-9293
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4143 HAYWOOD RD
Second Line	:
City	:	MILLS RIVER
State	:	NC
Zip	:	28759-9740
Country	:	US
Telephone Number	:	828-891-2166
Fax Number	:

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

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	08/08/2023

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Directions to “ JENNIFER HANSEN M.S., CCC-SLP” Practice Location

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