Provider Demographics
NPI:1518052943
Name:HAHN, MARILYN MARSHALL (PHD)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:MARSHALL
Last Name:HAHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4643 SUMMERLAND TRAIL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6149
Mailing Address - Country:US
Mailing Address - Phone:814-833-7476
Mailing Address - Fax:814-838-7743
Practice Address - Street 1:3939 WEST RIDGE ROAD, SUITE B-23
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506
Practice Address - Country:US
Practice Address - Phone:814-835-1107
Practice Address - Fax:814-838-7743
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006196L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical