Provider Demographics
NPI:1366215436
Name:HANLEY, NATHAN PATRICK
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:PATRICK
Last Name:HANLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S BATES ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-2527
Mailing Address - Country:US
Mailing Address - Phone:989-980-7044
Mailing Address - Fax:
Practice Address - Street 1:203 S WASHINGTON AVE STE 30
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1217
Practice Address - Country:US
Practice Address - Phone:989-209-3245
Practice Address - Fax:989-209-3246
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician