Provider Demographics
NPI:1861068793
Name:MOHAGEN, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MOHAGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:
Other - Last Name:BRENNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2600 DALLAS PKWY STE 290
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7493
Mailing Address - Country:US
Mailing Address - Phone:945-260-0010
Mailing Address - Fax:
Practice Address - Street 1:1100 19TH AVE N STE K
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2269
Practice Address - Country:US
Practice Address - Phone:701-235-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist