Provider Demographics
NPI:1982819439
Name:ARMENTROUT, BECKY JO (OT)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:JO
Last Name:ARMENTROUT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3963 SUGAR CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-8558
Mailing Address - Country:US
Mailing Address - Phone:419-221-0108
Mailing Address - Fax:
Practice Address - Street 1:4392 STATE ROUTE 235
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810-9503
Practice Address - Country:US
Practice Address - Phone:419-634-8655
Practice Address - Fax:419-238-3612
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 04817225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist