Provider Demographics
NPI:1295386829
Name:AZZANO, HANNAH ROSE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ROSE
Last Name:AZZANO
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-4212
Mailing Address - Country:US
Mailing Address - Phone:480-577-1096
Mailing Address - Fax:
Practice Address - Street 1:800 N WATTERS RD STE 120
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5346
Practice Address - Country:US
Practice Address - Phone:469-804-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst