Provider Demographics
NPI:1043620800
Name:HANNA, JESSICA ALVES (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ALVES
Last Name:HANNA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6811
Mailing Address - Country:US
Mailing Address - Phone:508-397-2021
Mailing Address - Fax:
Practice Address - Street 1:74 TAUNTON ST STE G01
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2318
Practice Address - Country:US
Practice Address - Phone:508-964-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10654174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty