Provider Demographics
NPI:1346889235
Name:CHUNG, HANNAH (BCBA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CHUNG
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 1:1234 WILSHIRE BLVD APT 236
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1975
Mailing Address - Country:US
Mailing Address - Phone:213-713-2111
Mailing Address - Fax:
Practice Address - Street 1:1234 WILSHIRE BLVD APT 236
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1975
Practice Address - Country:US
Practice Address - Phone:213-713-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-25
Last Update Date:2019-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst