Provider Demographics
NPI:1295203164
Name:KOCH, AMY ROSE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ROSE
Last Name:KOCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROSE
Other - Last Name:BOTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7882 ALBRITTON PL
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 HADLEY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45218-1533
Practice Address - Country:US
Practice Address - Phone:513-484-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009675225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist