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NPI Code Detail

MEDICARE: HANNAH RYAN TRAVIS

MEDICARE: HANNAH RYAN TRAVIS
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
1106S00000XBehavior Technician23-281889KY

General Provider Information

NPI Number : 1992485759
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH RYAN TRAVIS
Provider Business Mailing Address
First Line : 298 MEDLEY CT
Second Line :
City : VINE GROVE
State : KY
Zip : 40175-8421
Country : US
Telephone Number : 502-827-3402
Fax Number :
Provider Business Practice Location Address
First Line : 298 MEDLEY CT
Second Line :
City : VINE GROVE
State : KY
Zip : 40175-8421
Country : US
Telephone Number : 270-352-1132
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2023
Last Update Date : 07/18/2023

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Directions to “ HANNAH RYAN TRAVIS ” Practice Location

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