Provider Demographics
NPI:1992818850
Name:HAHN, KATHRYN J (DOM)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:J
Last Name:HAHN
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
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Mailing Address - Street 1:1030 VALERIE CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-5055
Mailing Address - Country:US
Mailing Address - Phone:505-412-0157
Mailing Address - Fax:505-474-0496
Practice Address - Street 1:1925 ASPEN DR
Practice Address - Street 2:SUITE 502 B
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5459
Practice Address - Country:US
Practice Address - Phone:505-412-0157
Practice Address - Fax:505-474-0496
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM771171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist