Provider Demographics
NPI:1174372460
Name:GAVIOS, HANNAH MICHELE
Entity type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:MICHELE
Last Name:GAVIOS
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 1:176 WOODWARD AVE APT 329
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1377
Mailing Address - Country:US
Mailing Address - Phone:917-749-7511
Mailing Address - Fax:
Practice Address - Street 1:176 WOODWARD AVE APT 329
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1377
Practice Address - Country:US
Practice Address - Phone:917-749-7511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health