Provider Demographics
NPI:1518638667
Name:PUTTS, HANNAH CAMILLE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:CAMILLE
Last Name:PUTTS
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 1:210 CLORE RD
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1324
Mailing Address - Country:US
Mailing Address - Phone:360-490-7714
Mailing Address - Fax:
Practice Address - Street 1:210 CLORE RD
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1324
Practice Address - Country:US
Practice Address - Phone:360-490-7714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician