Provider Demographics
NPI:1649756743
Name:HOADLEY, ANN RENEE
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:RENEE
Last Name:HOADLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FAIRGROVE
Mailing Address - State:MI
Mailing Address - Zip Code:48733-5104
Mailing Address - Country:US
Mailing Address - Phone:989-282-5031
Mailing Address - Fax:
Practice Address - Street 1:1285 CLEAVER RD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9241
Practice Address - Country:US
Practice Address - Phone:989-672-0518
Practice Address - Fax:989-672-0887
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist