Individual
SHIRLEY ANN TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
335 W MCKINLEY WAY, POLAND, OH 44514-1681
(330) 757-2732
Mailing address
335 W MCKINLEY WAY, POLAND, OH 44514-1681
(330) 757-2732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-01087
OH
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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