MEDICARE: HANNAH KATE VAN METER BCBA

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	103K00000X	Behavior Analyst	1-24-74960	OH

General Provider Information

NPI Number	:	1154145209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH KATE VAN METER BCBA

Provider Business Mailing Address
First Line	:	95 EXECUTIVE PKWY STE 100
Second Line	:
City	:	HUDSON
State	:	OH
Zip	:	44236-5400
Country	:	US
Telephone Number	:	330-655-0946
Fax Number	:

Provider Business Practice Location Address
First Line	:	95 EXECUTIVE PKWY STE 100
Second Line	:
City	:	HUDSON
State	:	OH
Zip	:	44236-5400
Country	:	US
Telephone Number	:	330-655-0946
Fax Number	:

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

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	11/14/2024

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