Provider Demographics
NPI:1720621089
Name:HANCOCK, ANNE-MARIE ROSE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ANNE-MARIE
Middle Name:ROSE
Last Name:HANCOCK
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 1:302 COVE POINT TRAIL
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-3700
Mailing Address - Country:US
Mailing Address - Phone:434-420-0528
Mailing Address - Fax:
Practice Address - Street 1:302 COVE POINT TRAIL
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-3700
Practice Address - Country:US
Practice Address - Phone:434-420-0528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008280225X00000X
WV2081225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist