Provider Demographics
NPI:1932506615
Name:BRADSHAW, HANNAH MARY (OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARY
Last Name:BRADSHAW
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HELMAR DR
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-2210
Mailing Address - Country:US
Mailing Address - Phone:585-797-7167
Mailing Address - Fax:
Practice Address - Street 1:3599 BIG RIDGE RD
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1709
Practice Address - Country:US
Practice Address - Phone:585-352-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019163-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist