Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT2489 | OH |
NPI | 1164891206 |
---|---|
Provider Name | Peg Ebert |
First Address | Cincinnati, OH 45263-3448 |
Second Address | West Chester, OH 45069-7745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2015 |
Last Update Date | 25/11/2019 |