Provider Demographics
NPI:1679811061
Name:HANNA, VICTORIA R (MA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:R
Last Name:HANNA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:1440 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1236
Mailing Address - Country:US
Mailing Address - Phone:610-644-6464
Mailing Address - Fax:610-889-0732
Practice Address - Street 1:9003 LINCOLN DR W
Practice Address - Street 2:SUITE C
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3205
Practice Address - Country:US
Practice Address - Phone:610-644-6464
Practice Address - Fax:610-889-0732
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)