Provider Demographics
NPI:1972247419
Name:WUTZER, HANNAH (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:WUTZER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:GROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1809 INDIAN WELLS RD
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4617
Mailing Address - Country:US
Mailing Address - Phone:575-437-1967
Mailing Address - Fax:575-437-3969
Practice Address - Street 1:1451 GALWAY DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-7845
Practice Address - Country:US
Practice Address - Phone:575-437-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLP-2023-0082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist