Soukup, Tina L.

Soukup, Tina L. is an individual health care provider with primary practice located at 6451 Center St , Mentor OH 44060-4109. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Soukup, Tina L. can be contacted via phone (440) 255-4444.

Contact Information

Primary practice address
6451 Center St Mentor OH 44060-4109
Fax:
Website:

Health care specialties

Profile Details

NPI number 1124339205
LBN Legal business name Soukup, Tina L.
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2010
Last updated May 2nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124339205 NPPES
Ohio MEDICAID 0747777

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