Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 000837 | OH |
NPI | 1033340856 |
---|---|
Provider Name | Marijo Mccauley |
First Address | Canton, OH 44702-1083 |
Second Address | Canton, OH 44702-1083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2009 |
Last Update Date | 28/07/2009 |