Provider Demographics
NPI:1144879610
Name:HENSS, HANNAH ELISE (OTR)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELISE
Last Name:HENSS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2498 COUNTY ROAD 505 E
Mailing Address - Street 2:
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-5506
Mailing Address - Country:US
Mailing Address - Phone:217-493-7398
Mailing Address - Fax:
Practice Address - Street 1:2498 COUNTY ROAD 505 E
Practice Address - Street 2:
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-5506
Practice Address - Country:US
Practice Address - Phone:217-621-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT60964370225X00000X
IL056013546225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist