Provider Demographics
NPI:1598441834
Name:JOHNSON, HANNAH CHRISTINE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:CHRISTINE
Last Name:JOHNSON
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 1:2521 E MTN VILLAGE DRIVE
Mailing Address - Street 2:STE B PMB 797
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654
Mailing Address - Country:US
Mailing Address - Phone:907-671-6871
Mailing Address - Fax:
Practice Address - Street 1:780 S SNODGRASS DR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9149
Practice Address - Country:US
Practice Address - Phone:907-671-6871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor