Healthcare Provider Details

I. General information

NPI: 1649830811
Provider Name (Legal Business Name): VANESSA FLORA KLAWITTER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 06/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PROBASCO ST
CINCINNATI OH
45220-2710
US

IV. Provider business mailing address

169 SAINT ANNES DR
NORTH BEND OH
45052-9656
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-2464
  • Fax:
Mailing address:
  • Phone: 513-478-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010642
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: