Provider Demographics
NPI:1598442535
Name:HANEY, JANNAH LEIGH (COTA)
Entity Type:Individual
Prefix:
First Name:JANNAH
Middle Name:LEIGH
Last Name:HANEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 PRIVATE ROAD 8470
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75494-8824
Mailing Address - Country:US
Mailing Address - Phone:903-456-2430
Mailing Address - Fax:
Practice Address - Street 1:112 PRIVATE ROAD 8470
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-8824
Practice Address - Country:US
Practice Address - Phone:903-456-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics