Provider Demographics
NPI:1053134619
Name:HAN, HANGIL RUTH
Entity type:Individual
Prefix:
First Name:HANGIL
Middle Name:RUTH
Last Name:HAN
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:PO BOX 1912
Mailing Address - Street 2:
Mailing Address - City:SOUTHEASTERN
Mailing Address - State:PA
Mailing Address - Zip Code:19399-1912
Mailing Address - Country:US
Mailing Address - Phone:610-716-5576
Mailing Address - Fax:
Practice Address - Street 1:150 S WARNER RD STE 130
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2826
Practice Address - Country:US
Practice Address - Phone:610-716-5576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional