MEDICARE: HANNAH C CROUCH OTD, OTR/L

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	225XP0200X	Pediatric Occupational Therapist	2577	NE

General Provider Information

NPI Number	:	1073289765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH C CROUCH OTD, OTR/L

Provider Business Mailing Address
First Line	:	339 S 71ST ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68132-3343
Country	:	US
Telephone Number	:	307-761-4244
Fax Number	:

Provider Business Practice Location Address
First Line	:	8200 DODGE ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-4113
Country	:	US
Telephone Number	:	402-955-5400
Fax Number	:

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

Provider Enumeration Date	:	08/21/2021
Last Update Date	:	04/08/2026

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