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General NPI Number Information
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NPI Number | 1467275875
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Entity Type | Individual
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Provider Name | MARY ELIZABETH UHLS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 911 W MAIN ST
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City | EATON
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State | OH
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Zip | 45320-9520
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Country | US
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Telephone | 937-456-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 MEADOWSWEET DR
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City | ENGLEWOOD
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State | OH
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Zip | 45315-7730
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Country | US
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Telephone | 937-903-9333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA008494
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License Number State | OH
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