Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 970 | OH |
NPI | 1083166367 |
---|---|
Provider Name | Karen Lynn Stary |
First Address | Avon Lake, OH 44012-1819 |
Second Address | Avon Lake, OH 44012-1819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2016 |
Last Update Date | 02/11/2016 |