Provider Demographics
NPI:1528583440
Name:PRESCOTT, HANNAH (MHS, OTR/L, RBT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:MHS, OTR/L, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2579 NOAH STATION RD
Mailing Address - Street 2:
Mailing Address - City:KEYSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30816-4211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:727 W 6TH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-4407
Practice Address - Country:US
Practice Address - Phone:706-437-0505
Practice Address - Fax:706-437-0505
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-15-07966106S00000X
GAOT008168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician