Mrs. Traci Marie Hartrich
Occupational Therapist - Pediatrics
10354 Prairie Dell Rd
Shipman
, Illinois 62685-6105
Mrs. Traci Marie Hartrich
Occupational Therapist - Pediatrics
10354 Prairie Dell Rd
Shipman
, Illinois 62685-6105
(618) 836-7442
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About
Features
Specialties
- Occupational Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Mrs. Traci Marie Hartrich
- 10354 Prairie Dell Rd
- Shipman, IL
- Zip : 62685-6105
- Phone : (618) 836-7442
Second Address
- Mrs. Traci Marie Hartrich
- 10354 Prairie Dell Rd
- Shipman, IL
- Zip : 62685-6105
- Phone : (618) 836-7442
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0200X | Occupational Therapist - Pediatrics | 056002189 | IL |
National Provider Identifier
| NPI | 1063785020 |
|---|---|
| Provider Name | Mrs. Traci Marie Hartrich |
| First Address | Shipman, IL 62685-6105 |
| Second Address | Shipman, IL 62685-6105 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/02/2012 |
| Last Update Date | 21/02/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.