Healthcare Provider Details

I. General information

NPI: 1437089042
Provider Name (Legal Business Name): MARY ANIS HANNA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 ROCHESTER HWY STE A1
SENECA SC
29672-2463
US

IV. Provider business mailing address

204 ROANOKE WAY
GREENVILLE SC
29607-5495
US

V. Phone/Fax

Practice location:
  • Phone: 864-380-6488
  • Fax: 864-210-5209
Mailing address:
  • Phone: 864-800-9256
  • Fax: 864-210-5209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: