Healthcare Provider Details

I. General information

NPI: 1548646292
Provider Name (Legal Business Name): LAURA ANNE HINK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 RANCOCAS RD
BURLINGTON NJ
08016
US

IV. Provider business mailing address

5203 BAY RD
BENSALEM PA
19020
US

V. Phone/Fax

Practice location:
  • Phone: 609-387-9300
  • Fax:
Mailing address:
  • Phone: 267-306-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00702900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC013573
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: