Provider Demographics
NPI:1881100824
Name:BATTS, JACKIE (OTR)
Entity type:Individual
Prefix:
First Name:JACKIE
Middle Name:
Last Name:BATTS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JACKIE
Other - Middle Name:
Other - Last Name:OUIMET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:337 EDDINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5132 SCHUYLKILL ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2551
Practice Address - Country:US
Practice Address - Phone:614-989-9461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-4892225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist