Provider Demographics
NPI:1720188386
Name:HANNA, EDWARD P (DSW)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:P
Last Name:HANNA
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-1602
Mailing Address - Country:US
Mailing Address - Phone:610-796-8131
Mailing Address - Fax:610-796-8131
Practice Address - Street 1:118 S 5TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1602
Practice Address - Country:US
Practice Address - Phone:610-796-8131
Practice Address - Fax:610-796-8131
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-00330-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical