Provider Demographics
NPI:1427644921
Name:HANNA, RAEGAN LEE (MS, CF-SLP)
Entity type:Individual
Prefix:MISS
First Name:RAEGAN
Middle Name:LEE
Last Name:HANNA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 TREASURE LK
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-9013
Mailing Address - Country:US
Mailing Address - Phone:814-590-9148
Mailing Address - Fax:
Practice Address - Street 1:620 TREASURE LK
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-9013
Practice Address - Country:US
Practice Address - Phone:814-590-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist