Provider Demographics
NPI:1114022605
Name:HAHN, ALICE GRONA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:GRONA
Last Name:HAHN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ALICE
Other - Middle Name:GRONA
Other - Last Name:HUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1102 W TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624
Mailing Address - Country:US
Mailing Address - Phone:830-997-3781
Mailing Address - Fax:830-997-3786
Practice Address - Street 1:1102 W TRAVIS ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624
Practice Address - Country:US
Practice Address - Phone:830-997-3781
Practice Address - Fax:830-997-3786
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM01Q002OtherBCBS
NM10021599OtherLOVELACE
NMQMYPR0069979OtherMOLINA
NM5667188OtherFIRST HEALTH
NM656232OtherACN (UNITED HEALTH CARE)
NM202002416OtherPRESBYTERAIN
NM935544OtherCIGNA