MEDICARE: HANNAH EVERSON BCBA

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	103K00000X	Behavior Analyst	1-19-39653	MA

General Provider Information

NPI Number	:	1952941098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH EVERSON BCBA

Provider Business Mailing Address
First Line	:	19 HAMPSHIRE ST
Second Line	:
City	:	METHUEN
State	:	MA
Zip	:	01844-6808
Country	:	US
Telephone Number	:	508-233-2308
Fax Number	:	833-605-0180

Provider Business Practice Location Address
First Line	:	100 TREBLE COVE RD
Second Line	:
City	:	NORTH BILLERICA
State	:	MA
Zip	:	01862-2231
Country	:	US
Telephone Number	:	978-912-0570
Fax Number	:

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

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	08/24/2022

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