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NPI Code Detail

MEDICARE: ANA MAIRE HAGERTY OTR

MEDICARE: ANA MAIRE HAGERTY OTR
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 Therapist1000601OR
2225X00000XOccupational Therapist13-0341NV

General Provider Information

NPI Number : 1154562197
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA MAIRE HAGERTY OTR
Provider Business Mailing Address
First Line : 3030 S JONES BLVD
Second Line : SUITE 105
City : LAS VEGAS
State : NV
Zip : 89146-6792
Country : US
Telephone Number : 541-255-6213
Fax Number :
Provider Business Practice Location Address
First Line : 3030 S JONES BLVD STE 105
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6793
Country : US
Telephone Number : 702-360-1137
Fax Number : 702-240-1729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2009
Last Update Date : 09/09/2013

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Directions to “ ANA MAIRE HAGERTY OTR” Practice Location

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