Provider Demographics
NPI:1093321069
Name:TERRANOVA, HANNAH JOY (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:JOY
Last Name:TERRANOVA
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 1:7560 TRICA AVE NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-4059
Mailing Address - Country:US
Mailing Address - Phone:815-289-8974
Mailing Address - Fax:
Practice Address - Street 1:9951 MICKELBERRY RD NW STE 123
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8309
Practice Address - Country:US
Practice Address - Phone:360-286-2351
Practice Address - Fax:360-516-6786
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61043935225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist