Basic Information
Provider Information
NPI: 1144778747
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRAMMER
FirstName: HANNAH
MiddleName: JANE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 43 COCONUT LN
Address2:  
City: OCEAN RIDGE
State: FL
PostalCode: 334355202
CountryCode: US
TelephoneNumber: 5748074636
FaxNumber:  
Practice Location
Address1: 18370 LIMESTONE CREEK RD
Address2:  
City: JUPITER
State: FL
PostalCode: 334583860
CountryCode: US
TelephoneNumber: 5615986200
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/13/2016
LastUpdateDate: 09/19/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSZ7832FLY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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