Healthcare Provider Details

I. General information

NPI: 1578714002
Provider Name (Legal Business Name): CONSTANCE SCHITOSKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

5713 BRIDGETOWN RD
CINCINNATI OH
45248-3103
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA01505
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: