Individual
MS. TAMARA JO MICKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
230 S CROWN HILL RD, ORRVILLE, OH 44667-1328
(330) 682-2273
Mailing address
4877 15TH ST SW, CANTON, OH 44710-1158
(330) 418-3160
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA00819
OH
Other
Enumeration date
10/27/2012
Last updated
10/27/2012
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