Provider Demographics
NPI:1427740448
Name:BROOKSHIRE, HANNA ELISH
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:ELISH
Last Name:BROOKSHIRE
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 1:732 OLD CLAY PIT RD
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:KY
Mailing Address - Zip Code:42027-8521
Mailing Address - Country:US
Mailing Address - Phone:270-994-1335
Mailing Address - Fax:
Practice Address - Street 1:206 W 5TH ST
Practice Address - Street 2:
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960-1810
Practice Address - Country:US
Practice Address - Phone:628-524-9368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker