Provider Demographics
NPI:1720311384
Name:RAGAN, HANNAH GRACE (MSOT)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:GRACE
Last Name:RAGAN
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:GRACE
Other - Last Name:RENTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/R
Mailing Address - Street 1:982 EASTERN PARKWAY
Mailing Address - Street 2:#6
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217
Mailing Address - Country:US
Mailing Address - Phone:502-635-6397
Mailing Address - Fax:502-635-1147
Practice Address - Street 1:982 EASTERN PARKWAY
Practice Address - Street 2:#6
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217
Practice Address - Country:US
Practice Address - Phone:502-635-6397
Practice Address - Fax:502-635-1147
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR4287225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist