Provider Demographics
NPI:1346447687
Name:BROWN, JODI (OT)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6268 STATE ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:OH
Mailing Address - Zip Code:44234-9770
Mailing Address - Country:US
Mailing Address - Phone:330-774-6266
Mailing Address - Fax:330-965-9308
Practice Address - Street 1:70 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1911
Practice Address - Country:US
Practice Address - Phone:330-761-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6362225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH006362OtherSTATE LICENSE ST