Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 06555 | OH |
NPI | 1013460773 |
---|---|
Provider Name | Holli Hohenbrink |
First Address | Lima, OH 45805-1802 |
Second Address | Lima, OH 45805-1802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2016 |
Last Update Date | 29/07/2016 |