Healthcare Provider Details

I. General information

NPI: 1558039115
Provider Name (Legal Business Name): HANNA ASCHALEW TAFETE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12702 SCIENCE DR
ORLANDO FL
32826-3016
US

IV. Provider business mailing address

2102 MORRILTON CT
ORLANDO FL
32837-6779
US

V. Phone/Fax

Practice location:
  • Phone: 407-574-2073
  • Fax:
Mailing address:
  • Phone: 407-780-0289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: