Healthcare Provider Details

I. General information

NPI: 1326826678
Provider Name (Legal Business Name): HANNAH ANDLYN MANLEY MOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5265 N ACADEMY BLVD
COLORADO SPRINGS CO
80918-4060
US

IV. Provider business mailing address

6 N LINCOLN ST APT 501
DENVER CO
80203-3947
US

V. Phone/Fax

Practice location:
  • Phone: 888-701-9216
  • Fax:
Mailing address:
  • Phone: 214-356-5312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0008153
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: