Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT011671 | OH |
NPI | 1003583204 |
---|---|
Provider Name | Claire Colwell |
First Address | West Chester, OH 45069-6308 |
Second Address | Beavercreek, OH 45324-2268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2021 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0406425 | (05) | OH |