Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 007953 | OH |
NPI | 1437400306 |
---|---|
Provider Name | Mrs. Kayla Marie Brown |
First Address | Columbus, OH 43220-2262 |
Second Address | Columbus, OH 43220-2262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2012 |
Last Update Date | 02/10/2012 |