Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA007610 | OH |
NPI | 1013559137 |
---|---|
Provider Name | Natasha Sanders |
First Address | Sherwood, OH 43556-0288 |
Second Address | Defiance, OH 43512-1315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2019 |
Last Update Date | 09/10/2019 |