MEDICARE: HANEEN HAMED 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	SP.15158	OH
2	235Z00000X	Speech-Language Pathologist	30004831	NC

General Provider Information

NPI Number	:	1245814334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANEEN HAMED SLP

Provider Business Mailing Address
First Line	:	3484 BIRD AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-3114
Country	:	US
Telephone Number	:	616-570-5189
Fax Number	:

Provider Business Practice Location Address
First Line	:	3484 BIRD AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-3114
Country	:	US
Telephone Number	:	616-570-5189
Fax Number	:

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

Provider Enumeration Date	:	05/06/2021
Last Update Date	:	03/04/2026

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Directions to “ HANEEN HAMED SLP” Practice Location

Language	Start Address	Practice Location

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