Individual
MR. GARY HANNEMANN
Active
Individual
MR. GARY HANNEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0064381
NM
101YP2500X
Professional Counselor
Primary
1631
CO
101YP2500X
Professional Counselor
2624-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0064381
MENTAL HEALTH COUNSELOR
NM
01
—
1631
LPC
CO
01
—
2624-125
LPC
WI
Enumeration date
07/06/2006
Last updated
07/21/2022
Update your record
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