Provider Demographics
NPI:1497992200
Name:RIORDAN, JULIETTE LORAINE (MOT,OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:LORAINE
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 BURNET AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2556
Mailing Address - Country:US
Mailing Address - Phone:513-861-0300
Mailing Address - Fax:513-861-0121
Practice Address - Street 1:2517 BURNET AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2556
Practice Address - Country:US
Practice Address - Phone:513-861-0300
Practice Address - Fax:513-861-0121
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2321225X00000X
OH004970225X00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist