Provider Demographics
NPI:1710477641
Name:POPMA, HANNA VICTORIA (MA)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:VICTORIA
Last Name:POPMA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 W HARMONICA WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-6386
Mailing Address - Country:US
Mailing Address - Phone:503-880-7966
Mailing Address - Fax:503-659-8984
Practice Address - Street 1:410 S ORCHARD ST STE 184
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1293
Practice Address - Country:US
Practice Address - Phone:208-214-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ID5071741101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health