Provider Demographics
NPI:1194225219
Name:STRAIN, CAMILLE VALENTINE REID (COTA/L)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:VALENTINE REID
Last Name:STRAIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 NEEDHAM AVE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2336
Mailing Address - Country:US
Mailing Address - Phone:330-715-1137
Mailing Address - Fax:
Practice Address - Street 1:2910 LERMITAGE PL
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-5219
Practice Address - Country:US
Practice Address - Phone:330-688-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA005518224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant