Provider Demographics
NPI:1356936876
Name:LEFORT, HANNAH C
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:C
Last Name:LEFORT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FRIEDA AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5422
Mailing Address - Country:US
Mailing Address - Phone:314-229-6255
Mailing Address - Fax:
Practice Address - Street 1:1025 CHESTERFIELD POINTE PKWY
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-1957
Practice Address - Country:US
Practice Address - Phone:636-489-4116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO400859224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant