Healthcare Provider Details

I. General information

NPI: 1609569045
Provider Name (Legal Business Name): HANNAH LILLIAN TRUESDELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CARRIAGE LN UNIT B
CHARLESTON SC
29407-6010
US

IV. Provider business mailing address

6 CARRIAGE LN UNIT B
CHARLESTON SC
29407-6010
US

V. Phone/Fax

Practice location:
  • Phone: 843-297-8470
  • Fax:
Mailing address:
  • Phone: 843-297-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86126
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: