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General NPI Number Information
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NPI Number | 1679288898
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Entity Type | Individual
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Provider Name | HANNA MARSHALL OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 12915 63RD AVE N
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City | MAPLE GROVE
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State | MN
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Zip | 55369-6001
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Country | US
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Telephone | 952-826-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 43081 FOREST BLVD
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City | HARRIS
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State | MN
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Zip | 55032-3217
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Country | US
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Telephone | 763-691-3860
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 107043
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License Number State | MN
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