Individual
SHARITA PERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2270 PARK HILLS DR, FAIRBORN, OH 45324-3993
(937) 878-5004
Mailing address
5734 FISHER DR, HUBER HEIGHTS, OH 45424-5564
(937) 238-2447
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
04924
OH
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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