Provider Demographics
NPI:1003557463
Name:SIMENTAL, HANNAH LYNN
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LYNN
Last Name:SIMENTAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:LYNN
Other - Last Name:HACKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2610 112TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-6726
Mailing Address - Country:US
Mailing Address - Phone:940-282-1313
Mailing Address - Fax:
Practice Address - Street 1:2610 112TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-6726
Practice Address - Country:US
Practice Address - Phone:940-282-1313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer