Provider Demographics
NPI:1093851222
Name:NAMETH, LORETTA J (COTA)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:J
Last Name:NAMETH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 W RIVER RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:OH
Mailing Address - Zip Code:44280-9575
Mailing Address - Country:US
Mailing Address - Phone:330-483-4222
Mailing Address - Fax:
Practice Address - Street 1:4691 WINDFALL RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8705
Practice Address - Country:US
Practice Address - Phone:330-725-7751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02024224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant