Provider Demographics
NPI:1104679216
Name:FRAIN, HANNAH COLLINS (LAT, ATC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:COLLINS
Last Name:FRAIN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1659 COUNTRY WALK DR
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-8614
Mailing Address - Country:US
Mailing Address - Phone:251-656-9585
Mailing Address - Fax:
Practice Address - Street 1:70 TOWER PKWY
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3623
Practice Address - Country:US
Practice Address - Phone:203-432-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT17012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer