Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 007966 | OH |
NPI | 1023784402 |
---|---|
Provider Name | Libbie Earnsberger |
First Address | Wooster, OH 44691-7933 |
Second Address | Wooster, OH 44691-7933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2021 |
Last Update Date | 17/08/2021 |