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General NPI Number Information
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NPI Number | 1699475608
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Entity Type | Individual
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Provider Name | NAOMIA JO HARDY OTA
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 5070 LAMME RD
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City | MORAINE
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State | OH
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Zip | 45439-3266
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Country | US
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Telephone | 937-293-7703
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Fax |
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Provider Business Mailing Address
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Address Line | 7661 SHEPHERDESS DR
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-2320
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Country | US
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Telephone | 937-414-0737
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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 | 003366
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License Number State | OH
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