Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT006123 | OH |
N | 225XH1200X | Occupational Therapist - Hand | OT006123 | OH |
NPI | 1093099335 |
---|---|
Provider Name | Amy C Cruise |
First Address | Columbus, OH 43213-4491 |
Second Address | Columbus, OH 43213-4491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 16/04/2021 |