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General NPI Number Information
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NPI Number | 1023267671
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Entity Type | Individual
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Provider Name | JACQUELINE L HANNIGAN MS ED
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Gender | Female
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 2038 DARLINGTON OAK DR
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City | SEFFNER
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State | FL
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Zip | 33584-5477
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Country | US
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Telephone | 631-871-8173
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Fax | 813-654-6471
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Provider Business Mailing Address
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Address Line | 2038 DARLINGTON OAK DR
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City | SEFFNER
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State | FL
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Zip | 33584-5744
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Country | US
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Telephone | 631-871-8173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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