Provider Demographics
NPI:1366263972
Name:ANDERSON, HANNAH LEE (CEP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 CAMPUS DR STE G
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7165
Mailing Address - Country:US
Mailing Address - Phone:207-396-8700
Mailing Address - Fax:
Practice Address - Street 1:96 CAMPUS DR STE G
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7165
Practice Address - Country:US
Practice Address - Phone:207-396-8700
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
ME907194224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist