Provider Demographics
NPI:1922770189
Name:TRUITT, HANNAH GABRIELLE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:GABRIELLE
Last Name:TRUITT
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 1:660 WASHINGTON ST APT 15K
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-3227
Mailing Address - Country:US
Mailing Address - Phone:615-512-7011
Mailing Address - Fax:
Practice Address - Street 1:1493 CAMBRIDGE ST RM 239
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1099
Practice Address - Country:US
Practice Address - Phone:617-575-5399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist