Healthcare Provider Details

I. General information

NPI: 1861917635
Provider Name (Legal Business Name): ELEANOR HAUSFELD MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2017
Last Update Date: 08/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 PARK AVE
CINCINNATI OH
45206-1476
US

IV. Provider business mailing address

2651 BURNET AVE
CINCINNATI OH
45219-2551
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number008267
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number008267
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: