Provider Demographics
NPI:1760018923
Name:STEVENSON, HANNA ANNETTE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:ANNETTE
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HALSTAD
Mailing Address - State:MN
Mailing Address - Zip Code:56548-4125
Mailing Address - Country:US
Mailing Address - Phone:701-730-5422
Mailing Address - Fax:
Practice Address - Street 1:201 9TH ST W STE 2
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MN
Practice Address - Zip Code:56510-1279
Practice Address - Country:US
Practice Address - Phone:218-784-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105264225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology