Provider Demographics
NPI:1376368753
Name:MASSEY, HANNAH (COTA/L)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 HEATHER RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-3033
Mailing Address - Country:US
Mailing Address - Phone:307-249-7299
Mailing Address - Fax:
Practice Address - Street 1:4828 LJ PKWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7188
Practice Address - Country:US
Practice Address - Phone:346-420-5916
Practice Address - Fax:281-697-4270
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217837224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant