MEDICARE: MS. HANNAH MARTIN MA, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23259	OTHER	CA	CALIFORNIA STATE LICENSE
2	14087956	OTHER		ASHA LICENSE

General Provider Information

NPI Number	:	1750978672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH MARTIN MA, CCC-SLP

Provider Business Mailing Address
First Line	:	5228 OCEAN BREEZE CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-1361
Country	:	US
Telephone Number	:	562-879-9322
Fax Number	:

Provider Business Practice Location Address
First Line	:	5228 OCEAN BREEZE CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-1361
Country	:	US
Telephone Number	:	562-879-9322
Fax Number	:

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

Provider Enumeration Date	:	12/26/2020
Last Update Date	:	12/26/2020

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Directions to “ MS. HANNAH MARTIN MA, CCC-SLP” Practice Location

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