Provider Demographics
NPI:1740827021
Name:WEST, HANNAH SHELBY
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:SHELBY
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:SHELBY
Other - Last Name:WALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12222 S 1000 E STE 3
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-3203
Mailing Address - Country:US
Mailing Address - Phone:801-987-3592
Mailing Address - Fax:801-935-4946
Practice Address - Street 1:808 S 1200 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-3712
Practice Address - Country:US
Practice Address - Phone:870-826-6642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR106S00000X
1-23-63808103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician