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NPI Code Detail

MEDICARE: EMILIE CLAIRE HANNA

MEDICARE: EMILIE CLAIRE HANNA
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 Worker106265TX

General Provider Information

NPI Number : 1245919588
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILIE CLAIRE HANNA
Provider Business Mailing Address
First Line : 305 S BROADWAY AVE STE 603
Second Line :
City : TYLER
State : TX
Zip : 75702-7338
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 305 S BROADWAY AVE STE 603
Second Line :
City : TYLER
State : TX
Zip : 75702-7338
Country : US
Telephone Number : 903-939-9010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2023
Last Update Date : 07/13/2023

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Directions to “ EMILIE CLAIRE HANNA ” Practice Location

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