Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003337619 |
---|---|
Provider Name | Meghan Roach |
First Address | Richmond Hts, OH 44143-2565 |
Second Address | Highland Hills, OH 44128-2811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2017 |
Last Update Date | 05/07/2017 |