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NPI Code Detail

MEDICARE: JENNIFER HANKS OTR/L

MEDICARE:   JENNIFER  HANKS  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
1225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1821503509
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HANKS OTR/L
Provider Business Mailing Address
First Line : 7980 JUNIPER DR
Second Line :
City : PARK CITY
State : UT
Zip : 84098-5370
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2411
Country : US
Telephone Number : 801-707-1090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2017
Last Update Date : 12/04/2017

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Directions to “ JENNIFER HANKS OTR/L” Practice Location

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