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General NPI Number Information
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NPI Number | 1851781876
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Entity Type | Individual
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Provider Name | JESSICA HATCH OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 10130 S 222ND ST
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City | GRETNA
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State | NE
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Zip | 68028-4317
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Country | US
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Telephone | 402-359-8830
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Fax |
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Provider Business Mailing Address
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Address Line | 14505 GREBE ST
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City | BENNINGTON
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State | NE
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Zip | 68007-1224
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Country | US
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Telephone | 402-719-0359
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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 | 1558
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License Number State | NE
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