Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 5877 | OH |
NPI | 1003188871 |
---|---|
Provider Name | Debra K Ruby |
First Address | Portsmouth, OH 45662-4714 |
Second Address | Portsmouth, OH 45662-4714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2012 |
Last Update Date | 08/02/2012 |