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Individual

DEBORAH D. HANNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
100 EXECUTIVE WAY, SUITE 113, PONTE VEDRA BEACH, FL 32082
(904) 273-6747
(904) 273-6861
Mailing address
PO BOX 721, PONTE VEDRA BEACH, FL 32004-0721
(904) 273-6747
(904) 273-6861

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW3501
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
121221900216
CCN
FL
Enumeration date
10/11/2006
Last updated
09/19/2012
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