Provider Demographics
NPI:1104365436
Name:RETZINGER, DEBORAH A (OTL)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:RETZINGER
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 RED ROAN DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-9039
Mailing Address - Country:US
Mailing Address - Phone:513-325-1440
Mailing Address - Fax:
Practice Address - Street 1:1216 RED ROAN DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-9039
Practice Address - Country:US
Practice Address - Phone:513-325-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 3975225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics