Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | OTA 03451 | OH |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT.008140 | OH |
NPI | 1225219843 |
---|---|
Provider Name | Karla Ann Riste |
First Address | Huber Heights, OH 45424-7334 |
Second Address | Huber Heights, OH 45424-7334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2007 |
Last Update Date | 19/02/2015 |