=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992507198
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNAH DAWN BUSDIECKER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2025
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8336 MONROE RD RM 120
-----------------------------------------------------
City | LAMBERTVILLE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48144-9340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-807-0162
-----------------------------------------------------
Fax | 888-700-7159
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 434 SUNFISH LN
-----------------------------------------------------
City | TEMPERANCE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48182-3011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------