Provider Demographics
NPI:1427739135
Name:DEFORD, HANNAH KRISTEN
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:KRISTEN
Last Name:DEFORD
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 1:3300 AIRPORT RD TRLR B11
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-8103
Mailing Address - Country:US
Mailing Address - Phone:806-206-6073
Mailing Address - Fax:
Practice Address - Street 1:1401 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5012
Practice Address - Country:US
Practice Address - Phone:575-437-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLP-2023-0250231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist