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NPI Code Detail

MEDICARE: HANNAH DISMER LCSW, MSW, MPH, CSE

MEDICARE:   HANNAH  DISMER  LCSW, MSW, MPH, CSE
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
11041C0700XClinical Social Worker149023785IL

General Provider Information

NPI Number : 1174295034
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH DISMER LCSW, MSW, MPH, CSE
Provider Business Mailing Address
First Line : 1602 21ST ST
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-5397
Country : US
Telephone Number : 618-451-5722
Fax Number : 618-451-9092
Provider Business Practice Location Address
First Line : 1602 21ST ST
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-5397
Country : US
Telephone Number : 618-451-5722
Fax Number : 618-451-9092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2021
Last Update Date : 09/29/2021

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Directions to “ HANNAH DISMER LCSW, MSW, MPH, CSE” Practice Location

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