Provider Demographics
NPI:1942723663
Name:AGUILERA, HANNAH FAITH (LMSW)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:FAITH
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3316
Mailing Address - Country:US
Mailing Address - Phone:616-607-4772
Mailing Address - Fax:
Practice Address - Street 1:238 W 15TH ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3318
Practice Address - Country:US
Practice Address - Phone:616-607-4772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010996941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical