Hannah Marie Blake

Individual provider Active NPI Speech-Language Pathologist · Davison, MI

NPI 1265291306 · NPPES record last updated Mar 18, 2024

Key facts

NPI
1265291306
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
1214 Lempi Dr
Davison, MI 48423-2884
Phone
(810) 399-9779
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241017001316 MI Practitioner - Qualified Speech Language Pathologist 9133651979 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Rehabilitation & Wellness, L.L.C. Current
since Mar 5, 2025
Accepting new patients
Hamtramck Orthopedic Physical Therapy, Inc. Past Accepting new patients

Locations

184 N Main St
Ste A
Frankenmuth, MI 48734
Phone (989) 262-8500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

1214 Lempi Dr
Davison, MI 48423-2884

Mailing address

1214 Lempi Dr
Davison, MI 48423-2884
Phone (810) 399-9779

Other providers in Davison, MI

All providers in Davison, MI · Speech-Language Pathologist in Michigan

Sources for this page

Verify at the official NPI Registry.