Healthcare Provider Details
I. General information
NPI: 1144099219
Provider Name (Legal Business Name): KRISTIN RENEE FISHER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/29/2023
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
584 COUNTY LINE RD W
WESTERVILLE OH
43082-7295
US
IV. Provider business mailing address
584 COUNTY LINE RD W
WESTERVILLE OH
43082-7295
US
V. Phone/Fax
- Phone: 614-355-6061
- Fax:
- Phone: 614-425-2232
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | 007689 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: