Provider Demographics
NPI:1356575534
Name:HANNA, RICKI CHRISTINE (COTA)
Entity type:Individual
Prefix:MRS
First Name:RICKI
Middle Name:CHRISTINE
Last Name:HANNA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-4717
Mailing Address - Country:US
Mailing Address - Phone:620-251-1675
Mailing Address - Fax:
Practice Address - Street 1:849 E WASHINGTON ST
Practice Address - Street 2:HOWARD TWILIGHT MANOR
Practice Address - City:HOWARD
Practice Address - State:KS
Practice Address - Zip Code:67349
Practice Address - Country:US
Practice Address - Phone:620-374-2495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18 00509224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant