Individual
PAUL R HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAC
Contact information
Practice address
660 MORTHLAND DR STE A, VALPARAISO, IN 46385-4638
(219) 462-9200
(219) 465-1245
Mailing address
660 MORTHLAND DR STE A, VALPARAISO, IN 46385-4638
(219) 462-9200
(219) 465-1245
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000841A
IN
Other
Enumeration date
08/01/2011
Last updated
08/01/2011
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