Jenna Ellerbrock, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Archbold, OH
NPI 1104370097 · NPPES record last updated Aug 8, 2016
Key facts
- NPI
- 1104370097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 06547 (OH)
- Practice address
- 205 Nolan Pkwy
Archbold, OH 43502-8404 - Phone
- (567) 444-4800
- NPI assigned
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06547 | OH | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 06547 | OH | Yes |
Addresses
Primary practice location
205 Nolan Pkwy
Archbold, OH 43502-8404
Mailing address
205 Nolan Pkwy
Archbold, OH 43502-8404
Phone (567) 444-4800
Other providers in Archbold, OH
- Kimberly Hazel Drewes
- Cara Drummelsmith
- Allison Jean Durham
- Teresa Lynn Eicher
- Rebecca Elkins
- Mindy Ellerbrock
- Erin Elliott
- Addison Elser
- John D Emch OD
- Andrew John Emch
All providers in Archbold, OH · Occupational Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.