Individual
MRS. TRACEY HENNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6000 YOUNGSTOWN WARREN RD, NILES, OH 44446-4624
(330) 505-2800
Mailing address
3942 DEVON DR SE, WARREN, OH 44484-2632
(330) 856-1502
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.002868
OH
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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