Provider Demographics
NPI:1912176181
Name:SWALLOW, HANNAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:SWALLOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 S BOULEVARD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4731
Mailing Address - Country:US
Mailing Address - Phone:405-414-1069
Mailing Address - Fax:
Practice Address - Street 1:920 S BOULEVARD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-4731
Practice Address - Country:US
Practice Address - Phone:405-414-1069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK946103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical