Provider Demographics
NPI:1134837875
Name:PORTER, HANNAH RAE (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:RAE
Last Name:PORTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MARVEL CT
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4052
Mailing Address - Country:US
Mailing Address - Phone:410-822-4613
Mailing Address - Fax:410-822-6534
Practice Address - Street 1:808 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3650
Practice Address - Country:US
Practice Address - Phone:302-629-4024
Practice Address - Fax:302-629-6371
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECP022275T225100000X, 261QR0400X
MD29217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation