Provider Demographics
NPI:1861256356
Name:MAUST, HANNAH JEAN
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:JEAN
Last Name:MAUST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5180 WARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-2130
Mailing Address - Country:US
Mailing Address - Phone:504-273-9861
Mailing Address - Fax:
Practice Address - Street 1:5545 MURRAY AVE STE 204
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3898
Practice Address - Country:US
Practice Address - Phone:662-536-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6804101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor