Provider Demographics
NPI:1962559963
Name:HANNON, BARBARA DEVAN (MSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:DEVAN
Last Name:HANNON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HUNTER ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2524
Mailing Address - Country:US
Mailing Address - Phone:856-304-2255
Mailing Address - Fax:
Practice Address - Street 1:1874 MARLTON PIKE E
Practice Address - Street 2:SOCIETY HILL OFFICE PARK, SUITE 4
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2037
Practice Address - Country:US
Practice Address - Phone:856-424-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008586001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical