Provider Demographics
NPI:1912323619
Name:FITZSIMMONS, OLGA S (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:OLGA
Middle Name:S
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:OLGA
Other - Middle Name:S
Other - Last Name:FITZSIMMONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4801 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1084
Mailing Address - Country:US
Mailing Address - Phone:937-236-9965
Mailing Address - Fax:937-233-0161
Practice Address - Street 1:4801 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1084
Practice Address - Country:US
Practice Address - Phone:937-236-9965
Practice Address - Fax:937-233-0161
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-4407225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist