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NPI Code Detail

MEDICARE: HANNAH CRISP OT

MEDICARE: HANNAH CRISP OT
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
1225X00000XOccupational Therapist124246TX

General Provider Information

NPI Number : 1144032921
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH CRISP OT
Provider Business Mailing Address
First Line : PO BOX 932184
Second Line :
City : ATLANTA
State : GA
Zip : 31193-2184
Country : US
Telephone Number : 856-678-3484
Fax Number :
Provider Business Practice Location Address
First Line : 450 E LOOP 281 STE B1
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-7969
Country : US
Telephone Number : 903-757-7731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2025
Last Update Date : 01/21/2025

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Directions to “ HANNAH CRISP OT” Practice Location

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