Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT1961 | OH |
NPI | 1790012748 |
---|---|
Provider Name | Donya Marcel Hogston |
First Address | Maumee, OH 43537-9180 |
Second Address | Whitehouse, OH 43571-9813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2009 |
Last Update Date | 12/11/2009 |