MEDICARE: VICTORIA S HANNAWA

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	7101009602	MI

General Provider Information

NPI Number	:	1588530612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA S HANNAWA

Provider Business Mailing Address
First Line	:	41703 JUNIPER CIR
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48377-1572
Country	:	US
Telephone Number	:	248-550-8049
Fax Number	:

Provider Business Practice Location Address
First Line	:	8906 COMMERCE RD STE 1
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4484
Country	:	US
Telephone Number	:	947-223-1609
Fax Number	:	248-716-9214

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

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	10/15/2025

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Directions to “ VICTORIA S HANNAWA ” Practice Location

Language	Start Address	Practice Location

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