Provider Demographics
NPI:1659093532
Name:NEIDING, ANASTASIA DIOR
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:DIOR
Last Name:NEIDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 KATHERINE AVE APT G
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3677
Mailing Address - Country:US
Mailing Address - Phone:419-366-6694
Mailing Address - Fax:
Practice Address - Street 1:1407 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3532
Practice Address - Country:US
Practice Address - Phone:419-366-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA008258224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant