Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT-5613 | OH |
NPI | 1164797999 |
---|---|
Provider Name | Dionna Noonan |
First Address | Lima, OH 45804-3569 |
Second Address | Lima, OH 45804-3569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 13/03/2012 |