Provider Demographics
NPI:1063201705
Name:CALLISON, HANNAH MARIAH SUMMER (CDCA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIAH SUMMER
Last Name:CALLISON
Suffix:
Gender:
Credentials:CDCA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIAH SUMMER
Other - Last Name:RIDENOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:123 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-1707
Mailing Address - Country:US
Mailing Address - Phone:419-771-2078
Mailing Address - Fax:
Practice Address - Street 1:123 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-1707
Practice Address - Country:US
Practice Address - Phone:419-771-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator