Healthcare Provider Details

I. General information

NPI: 1912313917
Provider Name (Legal Business Name): DIANA V. HOHMANN OTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/27/2024
Certification Date: 07/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4490 PARKLAND DR
MYRTLE BEACH SC
29579-6821
US

IV. Provider business mailing address

41 MOUNT PLEASANT RD
COLUMBIA NJ
07832-2634
US

V. Phone/Fax

Practice location:
  • Phone: 908-268-4360
  • Fax:
Mailing address:
  • Phone: 908-268-4360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number46TA09008100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: