Healthcare Provider Details

I. General information

NPI: 1043933534
Provider Name (Legal Business Name): SIANA VERNOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/21/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N ERIE HWY
HAMILTON OH
45011-4263
US

IV. Provider business mailing address

2229 FREEMAN AVE
HAMILTON OH
45015-1116
US

V. Phone/Fax

Practice location:
  • Phone: 513-389-6319
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT010436
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: