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NPI Code Detail

MEDICARE: BRANDY JO HAHN LPC-IT

MEDICARE: BRANDY JO HAHN LPC-IT
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 Counselor10735-125WI

General Provider Information

NPI Number : 1730847906
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY JO HAHN LPC-IT
Provider Business Mailing Address
First Line : 330 S BROADWAY
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-1518
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 330 S BROADWAY
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-1518
Country : US
Telephone Number : 414-246-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2021
Last Update Date : 11/01/2024

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