Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 12684 | AZ |
Y | 2251P0200X | Physical Therapist - Pediatrics | 18076 | OH |
NPI | 1043752165 |
---|---|
Provider Name | Mrs. Bridget O'brien |
First Address | Columbus, OH 43219-3591 |
Second Address | Columbus, OH 43219-3591 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2016 |
Last Update Date | 03/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18076 | OCCUPATIONAL THERAPY, PHYSICAL THERAPY, AND ATHLETIC TRAINING BOARD OF OHIO (01) | OH |