Provider Demographics
NPI:1558141580
Name:HANNAH BOCAN LLC
Entity Type:Organization
Organization Name:HANNAH BOCAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:DANIELLE DIANNN
Authorized Official - Last Name:BOCAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:870-299-0064
Mailing Address - Street 1:6480 PASEO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-3545
Mailing Address - Country:US
Mailing Address - Phone:870-299-0064
Mailing Address - Fax:
Practice Address - Street 1:6480 PASEO DEL SOL
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-3545
Practice Address - Country:US
Practice Address - Phone:870-299-0064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty