Provider Demographics
NPI:1801379607
Name:HUNN, MARY ANNE REQUILMAN (OTR)
Entity Type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:REQUILMAN
Last Name:HUNN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3701
Mailing Address - Country:US
Mailing Address - Phone:972-800-4133
Mailing Address - Fax:832-467-8412
Practice Address - Street 1:8383 MEADOW RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3701
Practice Address - Country:US
Practice Address - Phone:214-239-6000
Practice Address - Fax:832-467-8412
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113612225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology