Provider Demographics
NPI:1598004657
Name:O'HANLON, KRISTEN M (OT/LT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:M
Last Name:O'HANLON
Suffix:
Gender:F
Credentials:OT/LT
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:M
Other - Last Name:RITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3621 WINDFALL TER
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4930
Mailing Address - Country:US
Mailing Address - Phone:443-742-0730
Mailing Address - Fax:
Practice Address - Street 1:3621 WINDFALL TER
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4930
Practice Address - Country:US
Practice Address - Phone:443-742-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT00996225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist