Provider Demographics
NPI:1649904483
Name:EBANKS, JOANNE HELEN (OTR/L)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:HELEN
Last Name:EBANKS
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 1:461 SKY WAY DR
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-1558
Mailing Address - Country:US
Mailing Address - Phone:419-386-7645
Mailing Address - Fax:
Practice Address - Street 1:461 SKY WAY DR
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-1558
Practice Address - Country:US
Practice Address - Phone:419-386-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT008342225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty