Healthcare Provider Details

I. General information

NPI: 1033994439
Provider Name (Legal Business Name): HANNAH L CARR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 COMMERCIAL ST
KLAMATH FALLS OR
97601-6214
US

IV. Provider business mailing address

3201 CAMPUS DR
KLAMATH FALLS OR
97601-8801
US

V. Phone/Fax

Practice location:
  • Phone: 541-885-1675
  • Fax: 541-885-1817
Mailing address:
  • Phone: 541-885-1675
  • Fax: 541-885-1817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2826609
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: