Provider Demographics
NPI:1477249324
Name:REIERSON, HANNA CARLEEN
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:CARLEEN
Last Name:REIERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W MONROE ST APT 1101
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-1744
Mailing Address - Country:US
Mailing Address - Phone:616-558-1084
Mailing Address - Fax:
Practice Address - Street 1:300 W CLARENDON AVE STE 470
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3475
Practice Address - Country:US
Practice Address - Phone:602-730-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical