Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 7449 | OH |
NPI | 1225666258 |
---|---|
Provider Name | Laura Jean Kovach |
First Address | Westlake, OH 44145-4932 |
Second Address | Rocky River, OH 44116-4144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2020 |
Last Update Date | 27/03/2020 |