Provider Demographics
NPI:1467973610
Name:HANNA, EMILY BLOCK (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BLOCK
Last Name:HANNA
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 STATE ROUTE 56 NW
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9001
Mailing Address - Country:US
Mailing Address - Phone:315-264-8858
Mailing Address - Fax:
Practice Address - Street 1:425 EDISON BLVD
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2253
Practice Address - Country:US
Practice Address - Phone:937-562-9706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT010028225X00000X
NYP06665225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist