Provider Demographics
NPI:1992083232
Name:MBURU, HANNAH N
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:N
Last Name:MBURU
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 1:340 PRINCETON WAY
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-2957
Mailing Address - Country:US
Mailing Address - Phone:770-788-1031
Mailing Address - Fax:
Practice Address - Street 1:340 PRINCETON WAY
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-2957
Practice Address - Country:US
Practice Address - Phone:770-788-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)