Basic Information
| Provider Information | |||||||||
| NPI: | 1720362957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER-HOSSEINI | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | ASHLEY | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8674 OLYMPIA DR | ||||||||
| Address2: | |||||||||
| City: | BYRON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610109540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157030629 | ||||||||
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| Practice Location | |||||||||
| Address1: | 209 9TH ST | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | ROCKFORD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611042235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8154894470 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2011 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 242.002037 | IL | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 146011289 | IL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.