Provider Demographics
NPI:1003694043
Name:SCHILLECI, HANNAH (LSSP)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:
Last Name:SCHILLECI
Suffix:
Gender:F
Credentials:LSSP
Other - Prefix:MS
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1709 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-2305
Mailing Address - Country:US
Mailing Address - Phone:210-213-4983
Mailing Address - Fax:
Practice Address - Street 1:1709 ARBOR DR
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-2305
Practice Address - Country:US
Practice Address - Phone:210-213-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM419106103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool