Healthcare Provider Details

I. General information

NPI: 1356775795
Provider Name (Legal Business Name): ABBY ENSER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2013
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4841 MONROE ST
TOLEDO OH
43623-4385
US

IV. Provider business mailing address

4841 MONROE ST
TOLEDO OH
43623-4385
US

V. Phone/Fax

Practice location:
  • Phone: 419-241-6219
  • Fax: 419-241-5912
Mailing address:
  • Phone: 419-241-6219
  • Fax: 419-241-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.007865
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: