Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XM0800X | Mental Health | OT-002977 | OH |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT-002977 | OH |
NPI | 1902331333 |
---|---|
Provider Name | Joan Hedrick |
First Address | Powell, OH 43065-6082 |
Second Address | Powell, OH 43065-6082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2017 |
Last Update Date | 24/04/2017 |