Provider Demographics
NPI:1235626607
Name:CAIN, HANNAH KRISTIN (MS)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:KRISTIN
Last Name:CAIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:KRISTIN
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 MEDPARK DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2734
Mailing Address - Country:US
Mailing Address - Phone:606-679-1761
Mailing Address - Fax:
Practice Address - Street 1:175 MEDPARK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2734
Practice Address - Country:US
Practice Address - Phone:606-679-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY241152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist