Individual
PEGGY LORRAINE HANAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1090 S GILBERT RD STE 106, GILBERT, AZ 85296-3439
(518) 268-9538
Mailing address
4865 E TEPEE ST, APACHE JUNCTION, AZ 85119-8977
(518) 268-9538
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006919
AZ
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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