Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003424052 |
---|---|
Provider Name | Shea Lynn Tijerina |
First Address | Lima, OH 45804-1240 |
Second Address | Findlay, OH 45840-4459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2020 |
Last Update Date | 15/07/2020 |