Healthcare Provider Details

I. General information

NPI: 1851476311
Provider Name (Legal Business Name): JASMINE SHROFF M.S. OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 01/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 ATTUCKS DR STE B
POWELL OH
43065-6082
US

IV. Provider business mailing address

8098 SUMMERHOUSE DR W
DUBLIN OH
43016-7066
US

V. Phone/Fax

Practice location:
  • Phone: 614-793-8720
  • Fax: 614-793-8722
Mailing address:
  • Phone: 614-214-6815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number006944
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: