Individual
LISA LYNN RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
230 W GALBRAITH RD, CINCINNATI, OH 45215-5223
(513) 948-2308
Mailing address
10383 CALVARY RD, INDEPENDENCE, KY 41051-9663
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
04768
OH
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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