Individual
MS. BONNIE J HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, OTRL
Contact information
Practice address
3905 UNIVERSITY DR, DURHAM, NC 27707-2517
(919) 928-0204
(919) 928-9423
Mailing address
3905 UNIVERSITY DR, DURHAM, NC 27707-2517
(919) 928-0204
(919) 928-9423
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
216
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301506
—
NC
Enumeration date
01/25/2007
Last updated
11/01/2012
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