Healthcare Provider Details
I. General information
NPI: 1942729256
Provider Name (Legal Business Name): ALICIA HAMMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/18/2017
Last Update Date: 09/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 HAMILTON AVE
COLUMBUS OH
43211-2115
US
IV. Provider business mailing address
533 W RIVER DR
GROVE CITY OH
43123-8668
US
V. Phone/Fax
- Phone: 614-365-5229
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | OT007928 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: