Individual
RILEY JANE HASENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1956 S 1025 E # R, BIRDSEYE, IN 47513-9419
(812) 639-0676
Mailing address
1956 S 1025 E # R, BIRDSEYE, IN 47513-9419
(812) 639-0676
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
IN
Enumeration date
11/28/2020
Last updated
11/28/2020
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