Provider Demographics
NPI:1376320861
Name:WHIPPLE, HANNAH RUTH SIUDA (LPC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:RUTH SIUDA
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:RUTH
Other - Last Name:SIUDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1315 LINDA LN APT 8
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2496
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:419 22ND AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-3812
Practice Address - Country:US
Practice Address - Phone:208-743-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-9581101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional