Provider Demographics
NPI:1861192486
Name:VILLAGE, HANNAH ELIZABETH (MT-BC, RBT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELIZABETH
Last Name:VILLAGE
Suffix:
Gender:F
Credentials:MT-BC, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 TECHNICAL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6107
Mailing Address - Country:US
Mailing Address - Phone:937-847-8750
Mailing Address - Fax:937-847-8753
Practice Address - Street 1:2570 TECHNICAL DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-6107
Practice Address - Country:US
Practice Address - Phone:937-847-8750
Practice Address - Fax:937-847-8753
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225A00000X
OH23-261536106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist