Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT. 009050 | OH |
NPI | 1003269655 |
---|---|
Provider Name | Lauren Michelle Becker |
First Address | Centerville, OH 45459-2541 |
Second Address | Centerville, OH 45459-2541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2016 |
Last Update Date | 19/07/2016 |