Provider Demographics
NPI:1154915783
Name:HARRIS, HANNAH NOEL
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:NOEL
Last Name:HARRIS
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 1:3771 PREAKNESS PL APT 1306
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-4365
Mailing Address - Country:US
Mailing Address - Phone:317-698-4292
Mailing Address - Fax:
Practice Address - Street 1:3771 PREAKNESS PL APT 1306
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4365
Practice Address - Country:US
Practice Address - Phone:317-698-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician