Provider Demographics
NPI:1689161754
Name:NEVITT, HANNAH M
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:M
Last Name:NEVITT
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 1:91 ELLIOTT PL
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-4812
Mailing Address - Country:US
Mailing Address - Phone:516-507-8966
Mailing Address - Fax:
Practice Address - Street 1:91 ELLIOTT PL
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-4812
Practice Address - Country:US
Practice Address - Phone:516-507-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-15
Last Update Date:2018-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst