Provider Demographics
NPI:1922855998
Name:HERBACH, HANNAH MARY (BS SLPA)
Entity type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:MARY
Last Name:HERBACH
Suffix:
Gender:F
Credentials:BS SLPA
Other - Prefix:MISS
Other - First Name:HANNAH
Other - Middle Name:MARY
Other - Last Name:HERBACH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS SLPA
Mailing Address - Street 1:2250 AVENIDA MAGNIFICA APT C
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-6866
Mailing Address - Country:US
Mailing Address - Phone:951-463-6242
Mailing Address - Fax:
Practice Address - Street 1:2624 EL CAMINO REAL STE B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1250
Practice Address - Country:US
Practice Address - Phone:760-696-3456
Practice Address - Fax:760-696-3458
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72722355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty