Provider Demographics
NPI:1720489958
Name:JOHNSON, HANNAH M
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:M
Last Name:JOHNSON
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 1:4325 LAUREL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5364
Mailing Address - Country:US
Mailing Address - Phone:907-569-5665
Mailing Address - Fax:907-333-1524
Practice Address - Street 1:4325 LAUREL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5364
Practice Address - Country:US
Practice Address - Phone:907-569-5665
Practice Address - Fax:907-333-1524
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK77235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist