MEDICARE: MS. EMILY MARIE FROMHOLD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT011864	OH

General Provider Information

NPI Number	:	1760138481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY MARIE FROMHOLD

Provider Business Mailing Address
First Line	:	5446 DESERTGOLD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-3562
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2140 POGUE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-3234
Country	:	US
Telephone Number	:	513-321-9294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

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