Healthcare Provider Details

I. General information

NPI: 1245693423
Provider Name (Legal Business Name): LORA VEHRE COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27100 CEDAR RD
BEACHWOOD OH
44122-1109
US

IV. Provider business mailing address

6281 TRI RIDGE BLVD SUITE 100
LOVELAND OH
45140-8345
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-6500
  • Fax:
Mailing address:
  • Phone: 866-791-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA-05802
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: