Healthcare Provider Details

I. General information

NPI: 1942957931
Provider Name (Legal Business Name): HANNAH DUSSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4817 EHRLICH RD
TAMPA FL
33624-2037
US

IV. Provider business mailing address

2035 SW 75TH ST STE B
GAINESVILLE FL
32607-3425
US

V. Phone/Fax

Practice location:
  • Phone: 877-823-4283
  • Fax: 352-332-8589
Mailing address:
  • Phone: 877-823-4283
  • Fax: 352-332-8589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17229
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: