Provider Demographics
NPI:1912529884
Name:AVERY, HANNAH KRISTYNE (MT-BC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:KRISTYNE
Last Name:AVERY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:KRISTYNE
Other - Last Name:STARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1648 MIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY CORNERS
Mailing Address - State:MI
Mailing Address - Zip Code:49060-9342
Mailing Address - Country:US
Mailing Address - Phone:517-392-2529
Mailing Address - Fax:
Practice Address - Street 1:1648 MIDLAND DR
Practice Address - Street 2:
Practice Address - City:HICKORY CORNERS
Practice Address - State:MI
Practice Address - Zip Code:49060-9342
Practice Address - Country:US
Practice Address - Phone:517-392-2529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist