Provider Demographics
NPI:1336683523
Name:HANLON, MICHAEL (MS, BSL)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HANLON
Suffix:
Gender:M
Credentials:MS, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ASPINWALL
Mailing Address - State:PA
Mailing Address - Zip Code:15215-2923
Mailing Address - Country:US
Mailing Address - Phone:412-980-8647
Mailing Address - Fax:
Practice Address - Street 1:205 E 8TH ST
Practice Address - Street 2:
Practice Address - City:ASPINWALL
Practice Address - State:PA
Practice Address - Zip Code:15215-2923
Practice Address - Country:US
Practice Address - Phone:412-980-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003165103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst