Provider Demographics
NPI:1982290482
Name:HALBAKKEN, HANNAH RAE (OTR/L)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:RAE
Last Name:HALBAKKEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:RAE
Other - Last Name:BRENK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6701 70TH AVE S
Mailing Address - Street 2:
Mailing Address - City:HORACE
Mailing Address - State:ND
Mailing Address - Zip Code:58047-9577
Mailing Address - Country:US
Mailing Address - Phone:218-849-0369
Mailing Address - Fax:
Practice Address - Street 1:627 33RD AVE W APT 203
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-7818
Practice Address - Country:US
Practice Address - Phone:218-849-0369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106334225X00000X
ND1798225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist