Healthcare Provider Details

I. General information

NPI: 1649663170
Provider Name (Legal Business Name): DENISE MCCLINTOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7947 TARTAN FIELDS DR
DUBLIN OH
43017-8778
US

IV. Provider business mailing address

5865 HUGHES RD
GALENA OH
43021-9793
US

V. Phone/Fax

Practice location:
  • Phone: 614-323-9469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.004880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: