Provider Demographics
NPI:1679954671
Name:HASAN, TONI (OTR/L)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:HASAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:RUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8455 HEATHERWOLD DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1233
Mailing Address - Country:US
Mailing Address - Phone:301-706-2067
Mailing Address - Fax:
Practice Address - Street 1:8455 HEATHERWOLD DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1233
Practice Address - Country:US
Practice Address - Phone:301-706-2067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist