Provider Demographics
NPI:1679143176
Name:HAMMUDEH, HANNAH MARIA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MARIA
Last Name:HAMMUDEH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIA
Other - Last Name:PEROTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:526 S DAVIN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-3110
Mailing Address - Country:US
Mailing Address - Phone:208-724-1261
Mailing Address - Fax:
Practice Address - Street 1:7285 W FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-0926
Practice Address - Country:US
Practice Address - Phone:208-853-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-40805104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker