Healthcare Provider Details

I. General information

NPI: 1124496781
Provider Name (Legal Business Name): MONICA HANCHAR B.S., COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 E US HIGHWAY 6
VALPARAISO IN
46383-8947
US

IV. Provider business mailing address

85 E US HIGHWAY 6
VALPARAISO IN
46383-8947
US

V. Phone/Fax

Practice location:
  • Phone: 219-983-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number057004246
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number32002822A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: