Provider Demographics
NPI:1972076586
Name:HAHN, ANNA (LAT, ATC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 HARWOOD AVE APT 321
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-2571
Mailing Address - Country:US
Mailing Address - Phone:262-853-5882
Mailing Address - Fax:
Practice Address - Street 1:18695 W CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53146-2231
Practice Address - Country:US
Practice Address - Phone:262-789-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1747-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer