Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 009255 | OH |
NPI | 1003279522 |
---|---|
Provider Name | Rebecca Humbert |
First Address | Westlake, OH 44145-1251 |
Second Address | Westlake, OH 44145-1251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 01/04/2016 |