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NPI Code Detail

MEDICARE: MS. FAITH L HANNAH LMSW

MEDICARE: MS. FAITH L HANNAH LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker1857-MAR

General Provider Information

NPI Number : 1114050416
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. FAITH L HANNAH LMSW
Provider Business Mailing Address
First Line : 900 HANEY AVE
Second Line :
City : EL DORADO
State : AR
Zip : 71730-4235
Country : US
Telephone Number : 870-500-4656
Fax Number :
Provider Business Practice Location Address
First Line : 412 N WASHINGTON AVE
Second Line :
City : EL DORADO
State : AR
Zip : 71730-5616
Country : US
Telephone Number : 870-863-4611
Fax Number : 870-863-4962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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Directions to “ MS. FAITH L HANNAH LMSW” Practice Location

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