Healthcare Provider Details

I. General information

NPI: 1992497333
Provider Name (Legal Business Name): HANNAH MCMINN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 S MAIN AVE
SCRANTON PA
18504-2545
US

IV. Provider business mailing address

97 SLOCUM ST APT 2
FORTY FORT PA
18704-4040
US

V. Phone/Fax

Practice location:
  • Phone: 570-468-5191
  • Fax:
Mailing address:
  • Phone: 570-468-5191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: