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NPI Code Detail

MEDICARE: MS. BONNIE J HACKER MHS, OTRL

MEDICARE: MS. BONNIE J HACKER MHS, OTRL
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 Therapist216NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871649731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BONNIE J HACKER MHS, OTRL
Provider Business Mailing Address
First Line : 3905 UNIVERSITY DR
Second Line :
City : DURHAM
State : NC
Zip : 27707-2517
Country : US
Telephone Number : 919-928-0204
Fax Number : 919-928-9423
Provider Business Practice Location Address
First Line : 3905 UNIVERSITY DR
Second Line :
City : DURHAM
State : NC
Zip : 27707-2517
Country : US
Telephone Number : 919-928-0204
Fax Number : 919-928-9423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 11/01/2012

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