Provider Demographics
NPI:1750675062
Name:HASKELL, ANNA (OTR/L, CHES)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HASKELL
Suffix:
Gender:F
Credentials:OTR/L, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 OVERLOOK CT
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-9453
Mailing Address - Country:US
Mailing Address - Phone:240-687-4070
Mailing Address - Fax:
Practice Address - Street 1:2525 RIVA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7411
Practice Address - Country:US
Practice Address - Phone:410-312-7631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06646225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist