Healthcare Provider Details

I. General information

NPI: 1225932361
Provider Name (Legal Business Name): NEURO EMPOWERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11440 ROSE LN
CINCINNATI OH
45246-2922
US

IV. Provider business mailing address

11440 ROSE LN
CINCINNATI OH
45246-2922
US

V. Phone/Fax

Practice location:
  • Phone: 513-667-6033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JEREMY ETISOMBA
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OTR/L, OTD, CNS
Phone: 513-667-6033