Healthcare Provider Details

I. General information

NPI: 1932848074
Provider Name (Legal Business Name): HANNAH WRAY HARDEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 W GREEN OAKS BLVD
ARLINGTON TX
76013-8314
US

IV. Provider business mailing address

725 WASHINGTON DR APT 5305
ARLINGTON TX
76011-3611
US

V. Phone/Fax

Practice location:
  • Phone: 817-457-3088
  • Fax:
Mailing address:
  • Phone: 513-594-7376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number122729
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: