Provider Demographics
NPI:1124695390
Name:SIMON, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STONE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:AMSTON
Mailing Address - State:CT
Mailing Address - Zip Code:06231-1220
Mailing Address - Country:US
Mailing Address - Phone:860-817-1989
Mailing Address - Fax:
Practice Address - Street 1:385 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4738
Practice Address - Country:US
Practice Address - Phone:860-646-0129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist