Provider Demographics
NPI:1497318463
Name:HECK HACKLEY, JAYNE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:HECK HACKLEY
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 1:11800 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ARM
Mailing Address - State:MD
Mailing Address - Zip Code:21057-9353
Mailing Address - Country:US
Mailing Address - Phone:443-604-8505
Mailing Address - Fax:
Practice Address - Street 1:11800 HARFORD RD
Practice Address - Street 2:
Practice Address - City:GLEN ARM
Practice Address - State:MD
Practice Address - Zip Code:21057-9353
Practice Address - Country:US
Practice Address - Phone:443-604-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist