Healthcare Provider Details

I. General information

NPI: 1689214652
Provider Name (Legal Business Name): NASTASSJA HANNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NASTASSJA ALANIA AGUIRRE

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 MONTEGO CT
DILLSBURG PA
17019-9382
US

IV. Provider business mailing address

17 MONTEGO CT
DILLSBURG PA
17019-9382
US

V. Phone/Fax

Practice location:
  • Phone: 717-825-5465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: