Healthcare Provider Details

I. General information

NPI: 1285561761
Provider Name (Legal Business Name): ERIN MARLO HASTERT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S 20TH ST
DENISON IA
51442-2251
US

IV. Provider business mailing address

1804 16TH ST
HARLAN IA
51537-1938
US

V. Phone/Fax

Practice location:
  • Phone: 712-263-3114
  • Fax:
Mailing address:
  • Phone: 712-540-4764
  • Fax: 712-540-4764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number097418
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: