Healthcare Provider Details

I. General information

NPI: 1609784669
Provider Name (Legal Business Name): HANNAH ALEXANDRA TATEEL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 STATE ROUTE 96
ASHLAND OH
44805-9262
US

IV. Provider business mailing address

1575 STATE ROUTE 96
ASHLAND OH
44805-9262
US

V. Phone/Fax

Practice location:
  • Phone: 419-895-1700
  • Fax:
Mailing address:
  • Phone: 419-895-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.03264
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: