Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 244507 | OH |
NPI | 1013256403 |
---|---|
Provider Name | Jessica Sumney |
First Address | Belle Center, OH 43310-9767 |
Second Address | Kenton, OH 43326-9506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2013 |
Last Update Date | 05/02/2013 |