Provider Demographics
NPI:1689620759
Name:RAGHAVAN, BHANU R (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BHANU
Middle Name:R
Last Name:RAGHAVAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9130 INDIAN SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9598
Mailing Address - Country:US
Mailing Address - Phone:937-885-7120
Mailing Address - Fax:937-885-7120
Practice Address - Street 1:9130 INDIAN SPRINGS CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-9598
Practice Address - Country:US
Practice Address - Phone:937-885-7120
Practice Address - Fax:937-885-7120
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 002338225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics