Healthcare Provider Details

I. General information

NPI: 1750053047
Provider Name (Legal Business Name): ERICKA HEATHER HOHMAN COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 10/04/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10225 RAVENNA RD
TWINSBURG OH
44087-1722
US

IV. Provider business mailing address

2462 TWIN LAKES DR
UNIONTOWN OH
44685-9719
US

V. Phone/Fax

Practice location:
  • Phone: 330-541-7064
  • Fax:
Mailing address:
  • Phone: 330-541-7064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA008084
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: