Provider Demographics
NPI:1932936143
Name:BLAESER, HANNAH ELAINE (MS, SLP CF)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELAINE
Last Name:BLAESER
Suffix:
Gender:F
Credentials:MS, SLP CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14105 S HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:NM
Mailing Address - Zip Code:88044-9461
Mailing Address - Country:US
Mailing Address - Phone:575-649-6414
Mailing Address - Fax:
Practice Address - Street 1:1431 GREENWAY DR STE 500
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2444
Practice Address - Country:US
Practice Address - Phone:877-688-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122512235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist