Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT010975 | OH |
NPI | 1275134496 |
---|---|
Provider Name | Amanda Rizzo |
First Address | Perrysburg, OH 43551-7186 |
Second Address | Pemberville, OH 43450-9413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2020 |
Last Update Date | 04/11/2020 |