Provider Demographics
NPI:1497173397
Name:HANS, TERESA (OTR/L)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HANS
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 1:12777 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 1504
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4775
Mailing Address - Country:US
Mailing Address - Phone:561-665-6467
Mailing Address - Fax:561-444-2811
Practice Address - Street 1:12777 FOREST HILL BLVD
Practice Address - Street 2:SUITE 1504
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4775
Practice Address - Country:US
Practice Address - Phone:561-665-6467
Practice Address - Fax:561-444-2811
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT16087225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist