Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 006736 | OH |
NPI | 1336620103 |
---|---|
Provider Name | Kimberly Hearl |
First Address | Kings Mills, OH 45034-9002 |
Second Address | Mason, OH 45040-1438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2018 |
Last Update Date | 28/08/2018 |