Provider Demographics
NPI:1629782982
Name:HALVERSON, HANNAH LEAH
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEAH
Last Name:HALVERSON
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 1:1015 S 40TH AVE # 21-23
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3806
Mailing Address - Country:US
Mailing Address - Phone:509-966-7246
Mailing Address - Fax:509-966-5731
Practice Address - Street 1:1015 S 40TH AVE # 21-23
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3806
Practice Address - Country:US
Practice Address - Phone:509-966-7246
Practice Address - Fax:509-966-5731
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health