Provider Demographics
NPI:1306667910
Name:DAMASO, HANNAH MARISSA
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARISSA
Last Name:DAMASO
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 1:1530 N 69TH WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5632
Mailing Address - Country:US
Mailing Address - Phone:305-781-5437
Mailing Address - Fax:
Practice Address - Street 1:1760 BELL TOWER LN STE 201
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3644
Practice Address - Country:US
Practice Address - Phone:954-684-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT5012106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist