Individual
HANNEMAE BROOK WASSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
414 E COEUR D'ALENE AVE, SUITE C, COEUR D'ALENE, ID 83814
(208) 277-0495
Mailing address
414 E COEUR D'ALENE AVE, SUITE C, COEUR D'ALENE, ID 83814
(208) 277-0495
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5571492
ID
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100815
—
WA
Enumeration date
04/25/2024
Last updated
05/04/2026
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