Healthcare Provider Details

I. General information

NPI: 1356286959
Provider Name (Legal Business Name): PATRICE HANING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 GENDER RD
CANAL WINCHESTER OH
43110-9046
US

IV. Provider business mailing address

8661 OAKSHIRE DR
PICKERINGTON OH
43147-7953
US

V. Phone/Fax

Practice location:
  • Phone: 614-920-2755
  • Fax:
Mailing address:
  • Phone: 859-466-1909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02640
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: