Provider Demographics
NPI:1336858851
Name:DELLECAVE, HANNAH MAE (BS, CLC, CPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MAE
Last Name:DELLECAVE
Suffix:
Gender:F
Credentials:BS, CLC, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HARTFORD TPKE APT 518
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-9400
Mailing Address - Country:US
Mailing Address - Phone:631-807-8812
Mailing Address - Fax:
Practice Address - Street 1:1100 HARTFORD TPKE APT 518
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-9400
Practice Address - Country:US
Practice Address - Phone:631-807-8812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA344922174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN