MEDICARE: HANNAH BIRKBECK 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
1	225X00000X	Occupational Therapist	117457	TX
2	225X00000X	Occupational Therapist	0119009540	VA

General Provider Information

NPI Number	:	1790145670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH BIRKBECK OTR

Provider Business Mailing Address
First Line	:	12880 HILLCREST RD STE 102
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1501
Country	:	US
Telephone Number	:	972-387-1100
Fax Number	:	972-692-7332

Provider Business Practice Location Address
First Line	:	7051 HEATHCOTE VILLAGE WAY STE 105
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3197
Country	:	US
Telephone Number	:	703-291-1254
Fax Number	:

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

Provider Enumeration Date	:	03/04/2016
Last Update Date	:	09/02/2022

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