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General NPI Number Information
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NPI Number | 1114826302
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Entity Type | Individual
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Provider Name | HANNAH FREDERICK MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 235 W MAIN ST STE F
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City | PERHAM
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State | MN
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Zip | 56573-1448
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Country | US
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Telephone | 218-325-1084
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Fax |
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Provider Business Mailing Address
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Address Line | 605 MAY AVE
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City | VINING
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State | MN
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Zip | 56588-8805
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Country | US
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Telephone | 218-770-0721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 32881
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License Number State | MN
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