Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 05317 | OH |
NPI | 1003247727 |
---|---|
Provider Name | Betsy Geddis |
First Address | West Jefferson, OH 43162-1298 |
Second Address | West Jefferson, OH 43162-1298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2013 |
Last Update Date | 05/12/2013 |