Provider Demographics
NPI:1780093799
Name:DAWANI, HANIA A
Entity type:Individual
Prefix:
First Name:HANIA
Middle Name:A
Last Name:DAWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:HANIA
Other - Middle Name:A
Other - Last Name:DAWANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, BS, MS, DNSC
Mailing Address - Street 1:CALIFORNIA STATE UNIVERSITY
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91330-8337
Mailing Address - Country:US
Mailing Address - Phone:508-650-0166
Mailing Address - Fax:508-655-3378
Practice Address - Street 1:304 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1124
Practice Address - Country:US
Practice Address - Phone:508-650-0166
Practice Address - Fax:508-655-3378
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2616912101YM0800X
MARN184303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health