Provider Demographics
NPI:1114658515
Name:REW, HANNAH GRACE
Entity Type:Individual
Prefix:
First Name:HANNAH GRACE
Middle Name:
Last Name:REW
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 1:1 OHIO UNIVERSITY DEP OF PSYCH
Mailing Address - Street 2:PORTER HALL ROOM 002
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2979
Mailing Address - Country:US
Mailing Address - Phone:740-593-0902
Mailing Address - Fax:740-593-4790
Practice Address - Street 1:1 OHIO UNIVERSITY DEP OF PSYCH
Practice Address - Street 2:PORTER HALL ROOM 002
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2979
Practice Address - Country:US
Practice Address - Phone:740-593-0902
Practice Address - Fax:740-593-4790
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program