Provider Demographics
NPI:1821765330
Name:SPLAJT, HANNAH LAURICE (LLMSW)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LAURICE
Last Name:SPLAJT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:LAURICE
Other - Last Name:TRUAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-9612
Mailing Address - Country:US
Mailing Address - Phone:616-466-1667
Mailing Address - Fax:
Practice Address - Street 1:303 144TH AVE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-9612
Practice Address - Country:US
Practice Address - Phone:616-466-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511107521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical