Healthcare Provider Details

I. General information

NPI: 1760042600
Provider Name (Legal Business Name): CLAIRE VANHOOSE OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 SPRINGFIELD ST
DAYTON OH
45431-1084
US

IV. Provider business mailing address

5715 CONCORD COMMONS DR
DAYTON OH
45459-7912
US

V. Phone/Fax

Practice location:
  • Phone: 937-236-9965
  • Fax:
Mailing address:
  • Phone: 937-681-0289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT012529
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: