Provider Demographics
NPI:1427214428
Name:HANNA-DWIGHT, EBONE N (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:EBONE
Middle Name:N
Last Name:HANNA-DWIGHT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 LULL WATER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-4524
Mailing Address - Country:US
Mailing Address - Phone:410-776-9408
Mailing Address - Fax:
Practice Address - Street 1:4286 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3247
Practice Address - Country:US
Practice Address - Phone:410-776-9408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist