Provider Demographics
NPI:1154513406
Name:DIDIER, HANNAH LEE (PTA)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:LEE
Last Name:DIDIER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 BISON LAKE CIR APT E
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0644
Mailing Address - Country:US
Mailing Address - Phone:317-258-5673
Mailing Address - Fax:
Practice Address - Street 1:651 STATE ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2552
Practice Address - Country:US
Practice Address - Phone:317-736-6414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002761A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant