Provider Demographics
NPI:1598366544
Name:JERUZALMI, HANNA (LGPC)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:JERUZALMI
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:
Other - Last Name:YERUSHALMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:134 HOLIDAY CT STE 312
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7008
Mailing Address - Country:US
Mailing Address - Phone:410-849-9434
Mailing Address - Fax:
Practice Address - Street 1:134 HOLIDAY CT STE 312
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7008
Practice Address - Country:US
Practice Address - Phone:410-849-9434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9773101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional