MEDICARE: HANNAH KEDZIORSKI 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	2994	NV

General Provider Information

NPI Number	:	1497418404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH KEDZIORSKI CCC-SLP

Provider Business Mailing Address
First Line	:	7350 W CENTENNIAL PKWY UNIT 2117
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-1651
Country	:	US
Telephone Number	:	702-553-8168
Fax Number	:

Provider Business Practice Location Address
First Line	:	2560 MONTESSOURI ST STE 113
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3063
Country	:	US
Telephone Number	:	702-553-8168
Fax Number	:

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

Provider Enumeration Date	:	10/16/2021
Last Update Date	:	10/16/2021

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Directions to “ HANNAH KEDZIORSKI CCC-SLP” Practice Location

Language	Start Address	Practice Location

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