Healthcare Provider Details

I. General information

NPI: 1265353759
Provider Name (Legal Business Name): HANNAH RYAN OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 W RUNNING DEER TRL
PHOENIX AZ
85085-7842
US

IV. Provider business mailing address

2821 W RUNNING DEER TRL
PHOENIX AZ
85085-7842
US

V. Phone/Fax

Practice location:
  • Phone: 802-535-7818
  • Fax:
Mailing address:
  • Phone: 802-535-7818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number010361
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: