MEDICARE: HANNAH LOUISE MASON

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	202835	AR

General Provider Information

NPI Number	:	1548099138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH LOUISE MASON

Provider Business Mailing Address
First Line	:	319 N CLOUDY LOOP UNIT A
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-4028
Country	:	US
Telephone Number	:	479-831-5359
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 S GRACE LN
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-2523
Country	:	US
Telephone Number	:	479-267-6024
Fax Number	:

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

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	07/31/2024

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Directions to “ HANNAH LOUISE MASON ” Practice Location

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