MEDICARE: HANNAH CALLAWAY BAISLEY 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	SLP5412	TN

General Provider Information

NPI Number	:	1295396208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH CALLAWAY BAISLEY CCC-SLP

Provider Business Mailing Address
First Line	:	508 RIDGE CT E
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-1209
Country	:	US
Telephone Number	:	615-715-3755
Fax Number	:

Provider Business Practice Location Address
First Line	:	3441 LEBANON PIKE STE 119
Second Line	:
City	:	HERMITAGE
State	:	TN
Zip	:	37076-2000
Country	:	US
Telephone Number	:	615-874-1400
Fax Number	:	629-666-3360

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

Provider Enumeration Date	:	06/21/2019
Last Update Date	:	06/30/2023

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Directions to “ HANNAH CALLAWAY BAISLEY CCC-SLP” Practice Location

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