Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT.007998 | OH |
NPI | 1003176421 |
---|---|
Provider Name | Dana Kristine Greenwell |
First Address | Columbus, OH 43220-3618 |
Second Address | Columbus, OH 43214-2458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2012 |
Last Update Date | 28/03/2017 |