Provider Demographics
NPI:1497515316
Name:PADILLA, HANNAH ROSE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ROSE
Last Name:PADILLA
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 1:1515 S LAMAR BLVD APT 1236
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2996
Mailing Address - Country:US
Mailing Address - Phone:956-537-8305
Mailing Address - Fax:
Practice Address - Street 1:2600 E BLUEBONNET LN
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-9319
Practice Address - Country:US
Practice Address - Phone:956-537-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health