Provider Demographics
NPI:1649993460
Name:DONOFRIO, HANNAH ELIZABETH MARCUM (BA, CCLS)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:ELIZABETH MARCUM
Last Name:DONOFRIO
Suffix:
Gender:F
Credentials:BA, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 WEATHERVANE LN
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-1356
Mailing Address - Country:US
Mailing Address - Phone:330-466-0026
Mailing Address - Fax:
Practice Address - Street 1:5905 BRECKSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-1517
Practice Address - Country:US
Practice Address - Phone:216-524-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2202656-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.2202656-TRNEOtherSOCIAL WORK TRAINEE