Basic Information
| Provider Information | |||||||||
| NPI: | 1497290324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANNAH | ||||||||
| FirstName: | BRITTANY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 ASSOCIATION DR | ||||||||
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| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253111270 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1011 PORTERS NECK RD | ||||||||
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| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284119196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106867195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2017 | ||||||||
| LastUpdateDate: | 01/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 11742 | NC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | 224Z00000X | C2114 | WV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.