Healthcare Provider Details

I. General information

NPI: 1588109359
Provider Name (Legal Business Name): ANGELA MONNIN ASMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 SPRINGFIELD ST
DAYTON OH
45431-1084
US

IV. Provider business mailing address

2072 PACER TRL
BEAVERCREEK TOWNSHIP OH
45434-5624
US

V. Phone/Fax

Practice location:
  • Phone: 937-236-9965
  • Fax:
Mailing address:
  • Phone: 937-236-9965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-3083
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: