Provider Demographics
NPI:1306546114
Name:CHOE, HANNAH NARA
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:NARA
Last Name:CHOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NARA
Other - Middle Name:
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30515-0123
Mailing Address - Country:US
Mailing Address - Phone:224-420-2005
Mailing Address - Fax:
Practice Address - Street 1:715 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2177
Practice Address - Country:US
Practice Address - Phone:470-822-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0082851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical