Individual
HANAKO VIVIAN BANNAI-HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
207 E MAIN ST, DOVER FOXCROFT, ME 04426-1246
(207) 564-3463
(207) 564-3900
Mailing address
207 E MAIN ST, DOVER FOXCROFT, ME 04426-1246
(207) 564-3463
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA4496
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OA4496
OCCUPATIONAL THERAPY ASSISTANT
ME
Enumeration date
08/02/2023
Last updated
08/02/2023
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