Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA-01540 | OH |
NPI | 1033233200 |
---|---|
Provider Name | Ms. Connie Sue Bendure |
First Address | Canton, OH 44718-1373 |
Second Address | Uniontown, OH 44685-8119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |