Basic Information
| Provider Information | |||||||||
| NPI: | 1801975453 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SABO | ||||||||
| FirstName: | JAYNE | ||||||||
| MiddleName: | LUGENE | ||||||||
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| Credential: | OT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DAVIS | ||||||||
| OtherFirstName: | JAYNE | ||||||||
| OtherMiddleName: | LUGENE | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3327 STATE ROUTE 422 NORTH WEST | ||||||||
| Address2: | |||||||||
| City: | SOUTHINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308984750 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8935 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444842353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308569532 | ||||||||
| FaxNumber: | 3308569622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.