Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT004200 | OH |
N | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1043524143 |
---|---|
Provider Name | Mrs. Connie Cantrell Butcher |
First Address | Strongsville, OH 44136-8603 |
Second Address | Strongsville, OH 44136-8603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2010 |
Last Update Date | 30/07/2010 |