Doctor Name: | TARA ELIZABETH-ANN HANNON |
NPI Number: | 1053518233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 4006 |
Business Practice Address: | 29 N Academy St Greenville, SC - 296012629 |
Business Phone Number: | 8643311350 |
Business Fax Number: | 8643311446 |
Mailing Address: | 1 Independence Pte, Ste 212 GREENVILLE |
State: | SC |
Postal Code: | 296154536 |
Phone Number: | 8647976307 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2007 |
NPI Last Update Date: | 11/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4006 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |