Provider Demographics
NPI:1033009071
Name:HANCOCK, RAVEN
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:
Last Name:HANCOCK
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 1:330 W MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-2304
Mailing Address - Country:US
Mailing Address - Phone:330-428-2994
Mailing Address - Fax:
Practice Address - Street 1:330 W MAIN ST APT 2
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2304
Practice Address - Country:US
Practice Address - Phone:330-428-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care