Provider Demographics
NPI:1356449490
Name:HANNAH, JANICE MURPHY (PH D)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:MURPHY
Last Name:HANNAH
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:ADELINE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 HIGH STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3423
Mailing Address - Country:US
Mailing Address - Phone:617-698-6003
Mailing Address - Fax:617-698-6004
Practice Address - Street 1:11 HIGH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3423
Practice Address - Country:US
Practice Address - Phone:617-698-6003
Practice Address - Fax:617-698-6004
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2446103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02644OtherMA BLUE CROSS BLUE SHIEL
MA723990OtherTUFTS HEALTH PLAN
W02644Medicare ID - Type Unspecified