Basic Information
| Provider Information | |||||||||
| NPI: | 1477179810 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAUCH | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | MICHELLE | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9152 W MEADOWBROOK AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850372382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7194828173 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12361 W BOLA DR STE 108 | ||||||||
| Address2: | |||||||||
| City: | SURPRISE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853789021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6237450828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2020 | ||||||||
| LastUpdateDate: | 06/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.