Provider Demographics
NPI:1295367498
Name:GUNSALUS, HANNAH E
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:E
Last Name:GUNSALUS
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 1:1135 SW ALL AMERICAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-3815
Mailing Address - Country:US
Mailing Address - Phone:772-349-5247
Mailing Address - Fax:
Practice Address - Street 1:NO ADDRESS
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-523-5377
Practice Address - Fax:561-658-0903
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician