Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT.008750 | OH |
NPI | 1043610603 |
---|---|
Provider Name | Miranda Ulrey |
First Address | Mount Gilead, OH 43338-9481 |
Second Address | Marengo, OH 43334-9738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2014 |
Last Update Date | 01/09/2014 |