Healthcare Provider Details

I. General information

NPI: 1073276358
Provider Name (Legal Business Name): HANNAH ELISE HOVIS MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 10/14/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

IV. Provider business mailing address

102 S ESTATES DR
SALINA KS
67401-3562
US

V. Phone/Fax

Practice location:
  • Phone: 402-570-2533
  • Fax:
Mailing address:
  • Phone: 402-570-2533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-03499
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: