Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 04125 | OH |
NPI | 1023616315 |
---|---|
Provider Name | Ms. Sandra Ann Vargas |
First Address | Oregon, OH 43616-1106 |
Second Address | Fairlawn, OH 44333-3339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2020 |
Last Update Date | 09/10/2020 |