Provider Demographics
NPI:1265948624
Name:ROLF, HANNAH ELIZABETH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELIZABETH
Last Name:ROLF
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 1:713 HOLBROOK AVE APT A
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-2094
Mailing Address - Country:US
Mailing Address - Phone:937-728-0446
Mailing Address - Fax:
Practice Address - Street 1:713 HOLBROOK AVE APT A
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2094
Practice Address - Country:US
Practice Address - Phone:937-728-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1701737104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker