Healthcare Provider Details

I. General information

NPI: 1053249995
Provider Name (Legal Business Name): HANNAH HANNACHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W UNIVERSITY DR
ROCHESTER MI
48307-1817
US

IV. Provider business mailing address

7231 IDA TER
WATERFORD MI
48329-2833
US

V. Phone/Fax

Practice location:
  • Phone: 248-266-0920
  • Fax:
Mailing address:
  • Phone: 248-787-3182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122159
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: