Basic Information
| Provider Information | |||||||||
| NPI: | 1841353984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANNEMAN | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21510 W 99TH ST | ||||||||
| Address2: | |||||||||
| City: | LENEXA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662202677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134926763 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3901 RAINBOW BLVD MSC 3010 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661600001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886719 | ||||||||
| FaxNumber: | 9135884676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 1965 | KS | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.