MEDICARE: BRITTANY KRISTENE HANRAHAN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	26297	MN

General Provider Information

NPI Number	:	1013764117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY KRISTENE HANRAHAN LICSW

Provider Business Mailing Address
First Line	:	PO BOX 2067
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56619-2067
Country	:	US
Telephone Number	:	218-368-5159
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 427
Second Line	:
City	:	REDLAKE
State	:	MN
Zip	:	56671-0427
Country	:	US
Telephone Number	:	218-407-0420
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2024
Last Update Date	:	05/06/2024

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