Provider Demographics
NPI:1346844289
Name:HANKAMP, MARGARET ANNE
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:HANKAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 16TH ST UNIT 204B
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6588
Mailing Address - Country:US
Mailing Address - Phone:845-300-0717
Mailing Address - Fax:
Practice Address - Street 1:200 16TH ST UNIT 204B
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6588
Practice Address - Country:US
Practice Address - Phone:845-300-0717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL77114225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist