Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5603 | OH |
NPI | 1134600950 |
---|---|
Provider Name | Kathleen Ondak |
First Address | Beachwood, OH 44122-1109 |
Second Address | Beachwood, OH 44122-1109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2018 |
Last Update Date | 29/08/2018 |