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NPI Code Detail

MEDICARE: MRS. HANNAH REBECCA BLACK MS CCC-SLP

MEDICARE: MRS. HANNAH REBECCA BLACK 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
1235Z00000XSpeech-Language Pathologist4824AL

General Provider Information

NPI Number : 1134722861
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HANNAH REBECCA BLACK MS CCC-SLP
Provider Business Mailing Address
First Line : 412 W CLOVERDALE RD
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-4264
Country : US
Telephone Number : 256-259-1505
Fax Number :
Provider Business Practice Location Address
First Line : 412 W CLOVERDALE RD
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-4264
Country : US
Telephone Number : 256-259-1505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2020
Last Update Date : 11/17/2020

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Directions to “ MRS. HANNAH REBECCA BLACK MS CCC-SLP” Practice Location

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