| Doctor Name: | KIMBERLY E HANNA |
| NPI Number: | 1134391337 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.I.C.S.W.; LADC-1 |
| License Number: | 189 |
| Business Practice Address: | 11 Cape Dr Suite 13 Mashpee, MA - 026493046 |
| Business Phone Number: | 6173475298 |
| Business Fax Number: | |
| Mailing Address: | 11 Cape Dr, Suite 13 MASHPEE |
| State: | MA |
| Postal Code: | 026493046 |
| Phone Number: | 6173475298 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2008 |
| NPI Last Update Date: | 03/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 189 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |