Basic Information
| Provider Information | |||||||||
| NPI: | 1003499187 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CULPEPPER | ||||||||
| FirstName: | HANNAH | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA-SPED-ABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 636 PRESTON BROOKS DR | ||||||||
| Address2: | |||||||||
| City: | CATAWBA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297049713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044019887 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 10926 S TRYON ST STE E | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282734154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552015498 | ||||||||
| FaxNumber: | 8888494249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2021 | ||||||||
| LastUpdateDate: | 11/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-21-54955 | SC | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.