Healthcare Provider Details
I. General information
NPI: 1184167652
Provider Name (Legal Business Name): HANLON THERAPY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2016
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 E 8TH ST
ASPINWALL PA
15215-2923
US
IV. Provider business mailing address
205 E 8TH ST
ASPINWALL PA
15215-2923
US
V. Phone/Fax
- Phone: 412-980-8647
- Fax:
- Phone: 412-980-8647
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | BH003165 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
HANLON
Title or Position: OWNER
Credential: MS, BSL
Phone: 412-980-8647