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NPI Code Detail

MEDICARE: SHANNON HANF BSW, LSW

MEDICARE:   SHANNON  HANF  BSW, LSW
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
1104100000XSocial WorkerS.1903684OH

General Provider Information

NPI Number : 1225695208
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON HANF BSW, LSW
Provider Business Mailing Address
First Line : 1161 RACE DR
Second Line :
City : TROY
State : OH
Zip : 45373-4227
Country : US
Telephone Number : 937-451-0811
Fax Number :
Provider Business Practice Location Address
First Line : 141 W 3RD ST
Second Line :
City : DAYTON
State : OH
Zip : 45402-1814
Country : US
Telephone Number : 937-461-5550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2019
Last Update Date : 05/24/2019

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Directions to “ SHANNON HANF BSW, LSW” Practice Location

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