Provider Demographics
NPI:1598004707
Name:MYERS, SHARON (OTA)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTA
Mailing Address - Street 1:205 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MOUNT BLANCHARD
Mailing Address - State:OH
Mailing Address - Zip Code:45867
Mailing Address - Country:US
Mailing Address - Phone:419-694-5335
Mailing Address - Fax:
Practice Address - Street 1:205 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MT. BLANCHARD
Practice Address - State:OH
Practice Address - Zip Code:45867
Practice Address - Country:US
Practice Address - Phone:419-694-5335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01157224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant