Provider Demographics
NPI:1285288217
Name:DOBROVOLNY, HANNAH (OT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:DOBROVOLNY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:HANANAH
Other - Middle Name:
Other - Last Name:ROBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5285
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5285
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3004 W FAIDLEY AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4109
Practice Address - Country:US
Practice Address - Phone:308-398-5170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist