=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477030468
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNA QEDAN ROGERS OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2018
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3721 6TH AVE S
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35222-2409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-939-1088
-----------------------------------------------------
Fax | 501-327-1738
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1034 MAIN ST # 340
-----------------------------------------------------
City | GARDENDALE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35071-3484
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-790-1270
-----------------------------------------------------
Fax | 479-790-1270
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OTR3158
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 6445
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------