Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 4347 | OH |
NPI | 1205064425 |
---|---|
Provider Name | Julie L Mirabell |
First Address | Ashtabula, OH 44004-2053 |
Second Address | Ashtabula, OH 44004-6424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 25/06/2009 |