Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 000929 | OH |
NPI | 1003026931 |
---|---|
Provider Name | Regina M Grywalski |
First Address | Delaware, OH 43015-7901 |
Second Address | Powell, OH 43065-6082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 05/09/2013 |