Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT000910 | OH |
NPI | 1043634033 |
---|---|
Provider Name | Mrs. Nancy Jo Bowman |
First Address | Toledo, OH 43612-2016 |
Second Address | Toledo, OH 43612-2016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2014 |
Last Update Date | 11/02/2014 |