Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225XM0800X | Mental Health |
NPI | 1609433184 |
---|---|
Provider Name | Lydia Cingle |
First Address | West Chester, OH 45069-6308 |
Second Address | West Chester, OH 45069-6308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2019 |
Last Update Date | 11/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2187155 | (05) | OH |