Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT5461 | OH |
N | 225XG0600X | Occupational Therapist - Gerontology | OT5461 | OH |
NPI | 1679906093 |
---|---|
Provider Name | Angela C Enlund |
First Address | Columbus, OH 43220-5423 |
Second Address | Columbus, OH 43220-5423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 21/08/2013 |