Healthcare Provider Details

I. General information

NPI: 1336075779
Provider Name (Legal Business Name): HANNAH R WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E MAIN ST
WATERBURY CT
06702-2310
US

IV. Provider business mailing address

141 E MAIN ST
WATERBURY CT
06702-2310
US

V. Phone/Fax

Practice location:
  • Phone: 203-574-9000
  • Fax: 203-574-9006
Mailing address:
  • Phone: 203-574-9000
  • Fax: 203-574-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number9684
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: