Provider Demographics
NPI:1881323277
Name:BROCKSTEIN, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BROCKSTEIN
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 1:1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY
Mailing Address - Street 2:PORTER HALL ROOM 002
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2942
Mailing Address - Country:US
Mailing Address - Phone:740-593-0902
Mailing Address - Fax:740-593-4790
Practice Address - Street 1:1 OHIO UNIVERSITY DEPT OF PSYCHOLOGY
Practice Address - Street 2:PORTER HALL ROOM 002
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2942
Practice Address - Country:US
Practice Address - Phone:740-593-0902
Practice Address - Fax:740-593-4790
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program