Individual
DOREEN LIETZOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
400 CAROLYN CT, MINERVA, OH 44657-8703
(330) 868-4104
(330) 868-7714
Mailing address
4255 CARAWAY CIR NW, MASSILLON, OH 44646-1318
(330) 232-1350
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.05324
OH
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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