Individual
HANNAH RAE PENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 W JOHNSON DR, TERRE HAUTE, IN 47802-5508
(812) 233-8833
Mailing address
1980 E WOODSMALL DR, TERRE HAUTE, IN 47802-4937
(812) 231-5269
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-1936484
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300059985
—
IN
Enumeration date
05/09/2019
Last updated
03/28/2023
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