Provider Demographics
NPI:1053969949
Name:PARRISH, HANNAH (MA, BCABA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MA, BCABA, CCC-SLP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14700 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-1999
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:419 S CORAL ST
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-2503
Practice Address - Country:US
Practice Address - Phone:231-258-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0-15-6771106E00000X
MI7101006394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst