Basic Information
| Provider Information | |||||||||
| NPI: | 1669104626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STITH | ||||||||
| FirstName: | MORGAN | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 830 BELL OAK ST | ||||||||
| Address2: | |||||||||
| City: | NEW CARLISLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453441755 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1885 N DAYTON LAKEVIEW RD | ||||||||
| Address2: | |||||||||
| City: | NEW CARLISLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453449101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9378458219 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2022 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT012056 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.