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Individual

SUSAN BAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1879 DEERFIELD RD, LEBANON, OH 45036-8602
(513) 720-3301
Mailing address
996 HAMLIN DR, MAINEVILLE, OH 45039-9814
(513) 720-3301

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6059
OH

Other

Enumeration date
05/22/2017
Last updated
05/22/2017
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