Provider Demographics
NPI:1124641451
Name:STROM, HANNAH
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:STROM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13774 PLANTATION RD STE 105
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4461
Mailing Address - Country:US
Mailing Address - Phone:239-533-9860
Mailing Address - Fax:239-533-9860
Practice Address - Street 1:13774 PLANTATION RD STE 105
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4461
Practice Address - Country:US
Practice Address - Phone:239-533-9860
Practice Address - Fax:239-533-9860
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61059615101Y00000X
FLPY11736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor