Healthcare Provider Details

I. General information

NPI: 1386568855
Provider Name (Legal Business Name): HEATHER GREUTMAN COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 MIDDLETOWN EATON RD
MIDDLETOWN OH
45042-1525
US

IV. Provider business mailing address

5720 JACKSONBURG RD
TRENTON OH
45067-9672
US

V. Phone/Fax

Practice location:
  • Phone: 513-420-4750
  • Fax:
Mailing address:
  • Phone: 513-668-7312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA003654
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: