Provider Demographics
NPI:1073307971
Name:HANN, IAN JOSEPH (RBT)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:JOSEPH
Last Name:HANN
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21302 ENCINO CMNS APT 7208
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2727
Mailing Address - Country:US
Mailing Address - Phone:717-446-3629
Mailing Address - Fax:
Practice Address - Street 1:24200 W INTERSTATE 10 STE 109
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1150
Practice Address - Country:US
Practice Address - Phone:210-858-6933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB1262806106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst