Hannah Brunner

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

NPI 1376007724 · NPPES record last updated Nov 18, 2024

Key facts

NPI
1376007724
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7101009174 (MI)
Practice address
1161 E Clark Rd Ste 360
Dewitt, MI 48820-7962
Phone
(517) 507-5525
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
7101009174MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Speech-Language Pathologist Current
since Nov 28, 2024
Accepting new patients

Locations

1161 E Clark Rd
Ste 360
Dewitt, MI 48820
Phone (517) 507-5525

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101009174 MI Yes

Addresses

Primary practice location

1161 E Clark Rd Ste 360
Dewitt, MI 48820-7962

Mailing address

1161 E Clark Rd Ste 360
Dewitt, MI 48820-7962

Other names

  • Hannah Heidorn Former name

Other providers in Dewitt, MI

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

Sources for this page

Verify at the official NPI Registry.