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General NPI Number Information
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NPI Number | 1326842394
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Entity Type | Individual
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Provider Name | HANNAH ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 6525 GREEN BAY RD STE 2
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City | KENOSHA
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State | WI
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Zip | 53142-2967
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Country | US
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Telephone | 262-492-5276
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Fax |
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Provider Business Mailing Address
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Address Line | 472 SUMMIT AVE
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City | BURLINGTON
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State | WI
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Zip | 53105-1753
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5442
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License Number State | WI
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