Provider Demographics
NPI:1750984423
Name:THOMAS, HANNAH MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:THOMAS
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 1:530 FOSTER ST UNIT 236
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2494
Mailing Address - Country:US
Mailing Address - Phone:919-917-5889
Mailing Address - Fax:
Practice Address - Street 1:620 DR CALVIN JONES HWY STE 200
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-3100
Practice Address - Country:US
Practice Address - Phone:919-673-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13674225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty