Individual
AVERY BROOKE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2250 N MILLER CAMPUS DR, LEHI, UT 84043-7233
(833) 577-3422
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13798198-4102
UT
235Z00000X
Speech-Language Pathologist
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—
Other
Enumeration date
07/29/2024
Last updated
10/18/2024
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