Healthcare Provider Details

I. General information

NPI: 1083701072
Provider Name (Legal Business Name): KIRSTEN ERIN PATTERSON MA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 OLD TROY PIKE
DAYTON OH
45424-5740
US

IV. Provider business mailing address

8006 LAKEPOINTE DR BLDG #1
PLANTATION FL
33322-5726
US

V. Phone/Fax

Practice location:
  • Phone: 937-233-1230
  • Fax: 937-236-8930
Mailing address:
  • Phone: 954-370-8410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number11786
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number007137
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: