Mikaela Hansen

Individual provider Active NPI Speech-Language Pathologist · Broken Bow, NE

NPI 1902531155 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1902531155
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
912 (NE)
Practice address
1135 N H St
Broken Bow, NE 68822-1262
Phone
(308) 872-2982
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

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)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Broken Bow Public Schools County of Custer School District 25 Past
since Jul 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X 912 NE Yes

Addresses

Primary practice location

1135 N H St
Broken Bow, NE 68822-1262

Mailing address

1135 N H St
Broken Bow, NE 68822-1262
Phone (308) 872-2982

Other providers in Broken Bow, NE

All providers in Broken Bow, NE · Speech-Language Pathologist in Nebraska

Sources for this page

Verify at the official NPI Registry.