Healthcare Provider Details

I. General information

NPI: 1750166187
Provider Name (Legal Business Name): DENICE COCHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HEBRON RD
HEATH OH
43056-1040
US

IV. Provider business mailing address

1220 HEBRON RD
HEATH OH
43056-1040
US

V. Phone/Fax

Practice location:
  • Phone: 740-763-0408
  • Fax:
Mailing address:
  • Phone: 740-763-0408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number04535
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: