Provider Demographics
NPI:1023683877
Name:RICHARDSON, HANNAH MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:KERSTING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2598
Mailing Address - Country:US
Mailing Address - Phone:419-383-5040
Mailing Address - Fax:
Practice Address - Street 1:3615 NEWBURG RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3368
Practice Address - Country:US
Practice Address - Phone:502-909-0772
Practice Address - Fax:855-859-0123
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272645103G00000X
103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty