MEDICARE: HANNAH FLORENCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	2019002275	MO

General Provider Information

NPI Number	:	1003451980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH FLORENCE

Provider Business Mailing Address
First Line	:	6738 HANCOCK AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-2125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4471 OLIVE ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-1807
Country	:	US
Telephone Number	:	314-531-0982
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	11/14/2019

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Directions to “ HANNAH FLORENCE ” Practice Location

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