Provider Demographics
NPI:1831331370
Name:PATTERSON, ELIZABETH ANN HAYES (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN HAYES
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 MAYSTAR WAY
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-3010
Mailing Address - Country:US
Mailing Address - Phone:614-406-9092
Mailing Address - Fax:
Practice Address - Street 1:510 E NORTH BROADWAY ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4114
Practice Address - Country:US
Practice Address - Phone:614-263-5151
Practice Address - Fax:614-263-5365
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-7270225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094740Medicaid