Healthcare Provider Details

I. General information

NPI: 1700901444
Provider Name (Legal Business Name): TIMOTHY A DIRR OT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PROBASCO ST
CINCINNATI OH
45220-2710
US

IV. Provider business mailing address

7853 ANSON DR
NORTH BEND OH
45052-9501
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number006818
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: