Provider Demographics
NPI:1285214122
Name:DANG, HANH JENNIE
Entity Type:Individual
Prefix:
First Name:HANH
Middle Name:JENNIE
Last Name:DANG
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 1:2542 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6519
Mailing Address - Country:US
Mailing Address - Phone:727-453-1476
Mailing Address - Fax:
Practice Address - Street 1:2542 INDIGO DR
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6519
Practice Address - Country:US
Practice Address - Phone:727-453-1476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician