Provider Demographics
NPI:1730566050
Name:HAHN, KATRINA MAE (MED CCC SLP)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:MAE
Last Name:HAHN
Suffix:
Gender:F
Credentials:MED CCC SLP
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:802 S 1200 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-3712
Mailing Address - Country:US
Mailing Address - Phone:801-402-1619
Mailing Address - Fax:
Practice Address - Street 1:44 N. MARIO CAPECCHI DRIVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84114-4671
Practice Address - Country:US
Practice Address - Phone:801-584-8598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT554003235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist