Individual
BEVERLY SUE HANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2632 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-2845
(561) 632-3634
Mailing address
1789 SW MCALLISTER LN, PORT ST LUCIE, FL 34953-2047
(561) 632-3634
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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