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NPI Code Detail

MEDICARE: HANNAH GRIFFIN

MEDICARE: HANNAH GRIFFIN
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1366026817
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH GRIFFIN
Provider Business Mailing Address
First Line : 1915 MYRTLE AVE
Second Line :
City : BEARDSTOWN
State : IL
Zip : 62618-8009
Country : US
Telephone Number : 217-370-7594
Fax Number :
Provider Business Practice Location Address
First Line : 2100 5TH ST
Second Line :
City : LINCOLN
State : IL
Zip : 62656-9115
Country : US
Telephone Number : 217-732-3771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2021
Last Update Date : 05/11/2021

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Directions to “ HANNAH GRIFFIN ” Practice Location

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