Provider Demographics
NPI:1003569690
Name:HANNEY, LIANA (MS, LDN, RDN)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:HANNEY
Suffix:
Gender:F
Credentials:MS, LDN, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 ARTHUR B HENNESSEY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02556-2145
Mailing Address - Country:US
Mailing Address - Phone:843-371-0093
Mailing Address - Fax:
Practice Address - Street 1:43 ARTHUR B HENNESSEY RD
Practice Address - Street 2:
Practice Address - City:NORTH FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02556-2145
Practice Address - Country:US
Practice Address - Phone:843-371-0093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4037133V00000X
86061769133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered