Provider Demographics
NPI:1932644010
Name:MCMAHON-HARE, HILARIE JADE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:HILARIE
Middle Name:JADE
Last Name:MCMAHON-HARE
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 1:3926 N HILLS DR
Mailing Address - Street 2:
Mailing Address - City:AYDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28513-7140
Mailing Address - Country:US
Mailing Address - Phone:252-646-4736
Mailing Address - Fax:
Practice Address - Street 1:2626 GLENWOOD AVE STE 160
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-1367
Practice Address - Country:US
Practice Address - Phone:919-578-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7508224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant