Provider Demographics
NPI:1174285118
Name:SMITH, HANNAH LEIGH (BCBA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEIGH
Last Name:SMITH
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 1:231 E INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1732
Mailing Address - Country:US
Mailing Address - Phone:630-300-3444
Mailing Address - Fax:
Practice Address - Street 1:231 E INDIAN TRL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1732
Practice Address - Country:US
Practice Address - Phone:630-300-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-21-53797103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst