MEDICARE: ELIZABETH HAHN

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	103T00000X	Psychologist	20042294A	IN
2	103TC0700X	Clinical Psychologist	20042294A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508058165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH HAHN

Provider Business Mailing Address
First Line	:	20511 CHATHAM HILLS BLVD
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074-4338
Country	:	US
Telephone Number	:	317-679-9685
Fax Number	:

Provider Business Practice Location Address
First Line	:	20511 CHATHAM HILLS BLVD
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074-4338
Country	:	US
Telephone Number	:	317-679-9685
Fax Number	:

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	08/08/2024

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Directions to “ ELIZABETH HAHN ” Practice Location

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