Healthcare Provider Details

I. General information

NPI: 1700446473
Provider Name (Legal Business Name): HANNAH ELISABETH SPALDING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2019
Last Update Date: 07/16/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 SPRUCE ST
NORTH COLLINS NY
14111
US

IV. Provider business mailing address

2101 SPRUCE ST
NORTH COLLINS NY
14111
US

V. Phone/Fax

Practice location:
  • Phone: 716-337-3706
  • Fax: 716-337-2723
Mailing address:
  • Phone: 716-337-3706
  • Fax: 716-337-2723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: