Shawn Daniel Kill, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Delphos, OH

NPI 1104052166 · NPPES record last updated Jun 4, 2009

Key facts

NPI
1104052166
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
03760 (OH)
Practice address
21695 Griffin Rd
Delphos, OH 45833-8867
Phone
(419) 234-5885
NPI assigned
Jun 4, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
03760OHMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 03760 OH Yes

Addresses

Primary practice location

21695 Griffin Rd
Delphos, OH 45833-8867

Mailing address

21695 Griffin Rd
Delphos, OH 45833-8867
Phone (419) 234-5885

Other providers in Delphos, OH

All providers in Delphos, OH · Occupational Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.