Individual
TABITHA QUALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 MILLS PL, NEW LEBANON, OH 45345-1430
(937) 687-1311
(937) 687-3991
Mailing address
5293 MALLET CLUB DR, DAYTON, OH 45439-3278
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5761
OH
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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