Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA 03930 | OH |
NPI | 1003063470 |
---|---|
Provider Name | Jennifer Triplett |
First Address | Uniontown, OH 44685-6639 |
Second Address | North Canton, OH 44720-7137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2008 |
Last Update Date | 27/08/2008 |