Healthcare Provider Details

I. General information

NPI: 1467365486
Provider Name (Legal Business Name): HANNAH KAUP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WASHTENAW AVE STE 282
ANN ARBOR MI
48104-5184
US

IV. Provider business mailing address

4041 BERKELEY AVE
CANTON MI
48188-7229
US

V. Phone/Fax

Practice location:
  • Phone: 419-852-9710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6362010054
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: