Healthcare Provider Details

I. General information

NPI: 1811502602
Provider Name (Legal Business Name): HANNAH ELIZABETH SEKERAK OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S 1500 E
CLEARFIELD UT
84015-1613
US

IV. Provider business mailing address

8500 BLUFFSTONE CV
AUSTIN TX
78759-7808
US

V. Phone/Fax

Practice location:
  • Phone: 166-780-1896
  • Fax:
Mailing address:
  • Phone: 877-550-7804
  • Fax: 800-878-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11897137-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: