Healthcare Provider Details

I. General information

NPI: 1427168079
Provider Name (Legal Business Name): JOHN B HAMANN ED D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 RIVERSIDE DR
RIVER FALLS WI
54022-3236
US

IV. Provider business mailing address

PO BOX 425
RIVER FALLS WI
54022-0425
US

V. Phone/Fax

Practice location:
  • Phone: 715-425-7031
  • Fax: 715-425-1055
Mailing address:
  • Phone: 715-425-7031
  • Fax: 715-425-1055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number371-057
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number371-057
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number371-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: