Provider Demographics
NPI:1699841478
Name:HANLON, BARBARA ANN (OTLR)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:HANLON
Suffix:
Gender:F
Credentials:OTLR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 JUNIPER HILL LOOP
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9430
Mailing Address - Country:US
Mailing Address - Phone:505-286-8211
Mailing Address - Fax:
Practice Address - Street 1:5200 COPPER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1473
Practice Address - Country:US
Practice Address - Phone:505-255-5099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1551 OT225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist