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General NPI Number Information
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NPI Number | 1518670397
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Entity Type | Individual
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Provider Name | SYDNEY HENRY
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Gender | Female
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1879 DEERFIELD RD
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City | LEBANON
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State | OH
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Zip | 45036-9946
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Country | US
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Telephone | 513-695-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 157 CLARK AVE
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City | WAYNESVILLE
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State | OH
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Zip | 45068-8671
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Country | US
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Telephone | 937-728-8452
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA007968
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT012839
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License Number State | OH
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