Provider Demographics
NPI:1164990552
Name:RALENKOTTER, ELAINE M (OTR/L)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:RALENKOTTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 BURNET AVE # 4007
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2843
Mailing Address - Country:US
Mailing Address - Phone:859-344-4715
Mailing Address - Fax:859-344-4771
Practice Address - Street 1:3440 BURNET AVE # 4007
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2843
Practice Address - Country:US
Practice Address - Phone:859-344-4715
Practice Address - Fax:859-344-4771
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2911225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics