Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 000670 | OH |
NPI | 1104997535 |
---|---|
Provider Name | Dolores Jeanne Estep |
First Address | Springfield, OH 45503 |
Second Address | Springfield, OH 45503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 07/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2900696 | (05) | OH |