MEDICARE: JENNIFER HANN

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	106S00000X	Behavior Technician	RBT-25-444849	IN

General Provider Information

NPI Number	:	1477484426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HANN

Provider Business Mailing Address
First Line	:	418 E MISHAWAKA AVE
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-6820
Country	:	US
Telephone Number	:	574-323-0922
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 E MISHAWAKA AVE
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-6820
Country	:	US
Telephone Number	:	574-323-0922
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ JENNIFER HANN ” Practice Location

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