MEDICARE: MS. MARSHAE LYNNETTE OHMS ATR-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist	99-138

General Provider Information

NPI Number	:	1588873038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARSHAE LYNNETTE OHMS ATR-BC

Provider Business Mailing Address
First Line	:	1711 CHEROKEE DR
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-1825
Country	:	US
Telephone Number	:	513-543-4291
Fax Number	:

Provider Business Practice Location Address
First Line	:	1403 ALEXANDRIA PIKE
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2527
Country	:	US
Telephone Number	:	859-441-6332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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