Provider Demographics
NPI:1033568027
Name:CLEMENTS, HANNAH (BCBA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 E GENERAL STEWART WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-2636
Mailing Address - Country:US
Mailing Address - Phone:877-321-2899
Mailing Address - Fax:877-540-0182
Practice Address - Street 1:740 E GENERAL STEWART WAY STE 103
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-2636
Practice Address - Country:US
Practice Address - Phone:877-321-2899
Practice Address - Fax:877-540-0182
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-18-29691103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst