Healthcare Provider Details

I. General information

NPI: 1922993435
Provider Name (Legal Business Name): AMISHA HANA HAMANN LPC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMISHA PERO

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MAIN ST W
ASHLAND WI
54806-1639
US

IV. Provider business mailing address

22520 US HIGHWAY 63
GRAND VIEW WI
54839-4466
US

V. Phone/Fax

Practice location:
  • Phone: 715-685-2200
  • Fax:
Mailing address:
  • Phone: 715-292-0238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8457-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: