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General NPI Number Information
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NPI Number | 1295190387
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Entity Type | Individual
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Provider Name | KAREN JEAN LADERACH OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 2550 S STATE ROUTE 100
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City | TIFFIN
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State | OH
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Zip | 44883-9356
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Country | US
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Telephone | 419-447-7203
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Fax | 419-447-5577
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Provider Business Mailing Address
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Address Line | 1207 HURD AVE
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City | FINDLAY
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State | OH
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Zip | 45840-2215
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Country | US
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Telephone | 219-242-1161
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Fax |
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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 | OT.009122
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License Number State | OH
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