Healthcare Provider Details

I. General information

NPI: 1609584564
Provider Name (Legal Business Name): HANNAH MICHELE WINK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 ALEXANDER ST
JONESBORO LA
71251-2001
US

IV. Provider business mailing address

1000 CHINABERRY DR
BOSSIER CITY LA
71111-2438
US

V. Phone/Fax

Practice location:
  • Phone: 318-557-0451
  • Fax: 318-557-0451
Mailing address:
  • Phone: 318-224-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: