Healthcare Provider Details

I. General information

NPI: 1235514613
Provider Name (Legal Business Name): HANNAH SALANOA-OGBECHIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH HASAN

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 12/19/2020
Certification Date: 12/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BLUERIDGE AVE APT 337
WHEATON MD
20902-4568
US

IV. Provider business mailing address

2425 BLUERIDGE AVE APT 337
WHEATON MD
20902-4568
US

V. Phone/Fax

Practice location:
  • Phone: 909-274-8255
  • Fax:
Mailing address:
  • Phone: 909-274-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSYA00285
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: