Healthcare Provider Details

I. General information

NPI: 1497152375
Provider Name (Legal Business Name): JODIE MEYER COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11083 HAMILTON AVE
CINCINNATI OH
45231-1409
US

IV. Provider business mailing address

3705 KRIERVIEW DR
CINCINNATI OH
45248-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-674-4200
  • Fax:
Mailing address:
  • Phone: 513-203-1923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: