Provider Demographics
NPI:1487036174
Name:DAVIDSON, HANNAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:WOODSTOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:626 MAPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:626 MAPLE HILL DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1032
Practice Address - Country:US
Practice Address - Phone:269-544-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008764225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist