Provider Demographics
NPI:1700423746
Name:ALLSHOUSE, HANNAH KATHLEEN
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:KATHLEEN
Last Name:ALLSHOUSE
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 1:10900 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3349
Mailing Address - Country:US
Mailing Address - Phone:855-400-3455
Mailing Address - Fax:
Practice Address - Street 1:10900 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3349
Practice Address - Country:US
Practice Address - Phone:855-400-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKMSAN7390849OtherANTHEM