Provider Demographics
NPI:1972310563
Name:HAZELET, HANNAH LOUISE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LOUISE
Last Name:HAZELET
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40336 KELLY PARK RD
Mailing Address - Street 2:
Mailing Address - City:LEETONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44431-9639
Mailing Address - Country:US
Mailing Address - Phone:330-843-3316
Mailing Address - Fax:
Practice Address - Street 1:40336 KELLY PARK RD
Practice Address - Street 2:
Practice Address - City:LEETONIA
Practice Address - State:OH
Practice Address - Zip Code:44431-9639
Practice Address - Country:US
Practice Address - Phone:330-843-3316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.16210235Z00000X
WVSLP-2303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist