Provider Demographics
NPI:1962200022
Name:SMITH, HANNAH GRACE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:GRACE
Last Name:SMITH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8702 FOUNDERS RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1337
Mailing Address - Country:US
Mailing Address - Phone:317-452-9430
Mailing Address - Fax:
Practice Address - Street 1:8702 FOUNDERS RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1337
Practice Address - Country:US
Practice Address - Phone:317-452-9430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician