Healthcare Provider Details

I. General information

NPI: 1033647326
Provider Name (Legal Business Name): BARBARA GRANDISON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 VILLAGE PARK CT
COLUMBUS OH
43228-6416
US

IV. Provider business mailing address

1340 VILLAGE PARK CT
COLUMBUS OH
43228-6416
US

V. Phone/Fax

Practice location:
  • Phone: 614-560-1145
  • Fax:
Mailing address:
  • Phone: 614-560-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2399
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: