Provider Demographics
NPI:1851476311
Name:SHROFF, JASMINE (MS OTR)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:
Last Name:SHROFF
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8098 SUMMERHOUSE DR W
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-7066
Mailing Address - Country:US
Mailing Address - Phone:614-214-6815
Mailing Address - Fax:
Practice Address - Street 1:3833 ATTUCKS DR STE B
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6082
Practice Address - Country:US
Practice Address - Phone:614-793-8720
Practice Address - Fax:614-793-8722
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200700380AOtherPROVIDER # FOR FIRST STEP
OH1851476311OtherNPI