Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT-000034 | OH |
NPI | 1154873099 |
---|---|
Provider Name | Gayle Eble |
First Address | Mentor, OH 44060-3982 |
Second Address | Cleveland, OH 44109-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2016 |
Last Update Date | 26/10/2016 |