Provider Demographics
NPI:1992366942
Name:WALKER, HANAH MARIE
Entity Type:Individual
Prefix:
First Name:HANAH
Middle Name:MARIE
Last Name:WALKER
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 1:3267 SCHUST RD APT 107
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8110
Mailing Address - Country:US
Mailing Address - Phone:810-922-5511
Mailing Address - Fax:
Practice Address - Street 1:3267 SCHUST RD APT 107
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-8110
Practice Address - Country:US
Practice Address - Phone:810-922-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician