Individual
AMY HACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1921 ORTEGA ST, NAVARRE, FL 32566-4111
(850) 936-8919
Mailing address
1921 ORTEGA ST, NAVARRE, FL 32566-4111
(850) 936-8919
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009416
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OC009416
LICENSE
PA
01
—
OT 14358
FLORIDA OT LICENSE NUMBER
FL
Enumeration date
07/06/2006
Last updated
10/18/2013
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