Provider Demographics
NPI:1013221225
Name:SPENCE, HANNA
Entity Type:Individual
Prefix:MISS
First Name:HANNA
Middle Name:
Last Name:SPENCE
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 1:25941 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2723
Mailing Address - Country:US
Mailing Address - Phone:216-261-2055
Mailing Address - Fax:216-261-2050
Practice Address - Street 1:25941 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2723
Practice Address - Country:US
Practice Address - Phone:216-261-2055
Practice Address - Fax:216-261-2050
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33. 018625171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor