Provider Demographics
NPI:1083422950
Name:WICHARD, HANNAH RACHEL (OTR/L)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:RACHEL
Last Name:WICHARD
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 1:2308 OAKHAM CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3837
Mailing Address - Country:US
Mailing Address - Phone:201-819-7962
Mailing Address - Fax:
Practice Address - Street 1:15 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2001
Practice Address - Country:US
Practice Address - Phone:941-333-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01218000225X00000X
NY029708225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist