Provider Demographics
NPI:1417711334
Name:SMITH, HANNAH RENEE (RBT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:RENEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 MAHINAHINA PL
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-9356
Mailing Address - Country:US
Mailing Address - Phone:916-712-7115
Mailing Address - Fax:
Practice Address - Street 1:40 KUPUOHI ST STE 206
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-2714
Practice Address - Country:US
Practice Address - Phone:916-712-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-24-326242106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician