Provider Demographics
NPI:1831470822
Name:PETERS, HANNAH (PSYD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GROVE ST STE 402
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-7798
Mailing Address - Country:US
Mailing Address - Phone:781-205-9174
Mailing Address - Fax:
Practice Address - Street 1:8 GROVE ST STE 402
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7798
Practice Address - Country:US
Practice Address - Phone:781-205-9174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10453103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical