Provider Demographics
NPI:1740944750
Name:HANN, OLIVIA
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:HANN
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:PO BOX 3016
Mailing Address - Street 2:
Mailing Address - City:SOUTH HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07606-1016
Mailing Address - Country:US
Mailing Address - Phone:201-488-6678
Mailing Address - Fax:201-342-4346
Practice Address - Street 1:83 SUMMIT AVE STE 2
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1375
Practice Address - Country:US
Practice Address - Phone:201-488-6678
Practice Address - Fax:201-342-4346
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06664600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker