Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT003351 | OH |
NPI | 1043496805 |
---|---|
Provider Name | Heidi Youtsler |
First Address | West Chester, OH 45069-3804 |
Second Address | West Chester, OH 45069-3804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 11/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2187155 | (05) | OH |