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Individual

ANNALISE HANNAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
10184 E I25 FRONTAGE RD, FIRESTONE, CO 80504-5445
(720) 378-6670
Mailing address
1767 DEXTER ST, BROOMFIELD, CO 80020-2514
(757) 202-9684

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000523
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14299044
ASHA #
Enumeration date
07/14/2020
Last updated
07/14/2020
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