Provider Demographics
NPI:1891022315
Name:HACKER, SABRINA NICOLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:NICOLE
Last Name:HACKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 W FOX TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-7932
Mailing Address - Country:US
Mailing Address - Phone:606-598-6870
Mailing Address - Fax:
Practice Address - Street 1:376 MANCHESTER SQUARE SHOPPING CENTRE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962
Practice Address - Country:US
Practice Address - Phone:606-598-7673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist