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General NPI Number Information
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NPI Number | 1225362676
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Entity Type | Individual
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Provider Name | KRISTI L WANKER OT
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Gender | Female
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 2675 N LIPKEY RD
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City | NORTH JACKSON
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State | OH
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Zip | 44451-9665
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Country | US
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Telephone | 330-538-6228
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 CHURCHILL HUBBARD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1346
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Country | US
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Telephone | 330-759-5904
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Fax | 330-759-8709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4819
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License Number State | OH
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