Healthcare Provider Details

I. General information

NPI: 1932501392
Provider Name (Legal Business Name): ELIZABETH HAMMERSMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 GRAND AVE
CINCINNATI OH
45214-1502
US

IV. Provider business mailing address

1702 GRAND AVE
CINCINNATI OH
45214-1502
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6642
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: