Provider Demographics
NPI:1619445384
Name:KUYPER, HANNA (MA)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:KUYPER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 PARK MARINA CIR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0965
Mailing Address - Country:US
Mailing Address - Phone:530-710-4037
Mailing Address - Fax:
Practice Address - Street 1:353 PARK MARINA CIR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0965
Practice Address - Country:US
Practice Address - Phone:530-710-4037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109748106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist