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General NPI Number Information
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NPI Number | 1386494458
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Entity Type | Individual
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Provider Name | RUTH OVERTON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 2869 ESAW ST
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City | MINDEN
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State | NV
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Zip | 89423-9059
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Country | US
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Telephone | 425-923-9848
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Fax |
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Provider Business Mailing Address
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Address Line | 1494 TIROL DR
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451-7903
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Country | US
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Telephone |
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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-3211
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License Number State | NV
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