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General NPI Number Information
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NPI Number | 1497958219
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Entity Type | Individual
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Provider Name | THERESE MINJARES HAHN PH.D., O.M.D., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1405 LITTLE BLACKTAIL ROAD
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City | CAREYWOOD
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State | ID
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Zip | 83809
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Country | US
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Telephone | 208-683-5211
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Fax |
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Provider Business Mailing Address
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Address Line | P. O. BOX 341
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City | COCOLALLA
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State | ID
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Zip | 83813
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Country | US
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Telephone | 208-683-5211
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU3
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License Number State | ID
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