Provider Demographics
NPI:1083799647
Name:REDD, HANNAH MARTIN (LAC)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:MARTIN
Last Name:REDD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PRESIDENT DR
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3012
Mailing Address - Country:US
Mailing Address - Phone:401-261-4316
Mailing Address - Fax:
Practice Address - Street 1:140 POINT JUDITH RD
Practice Address - Street 2:SUITE 33C
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3477
Practice Address - Country:US
Practice Address - Phone:401-261-4316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA00162171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist