Provider Demographics
NPI: | 1942894498 |
---|---|
Name: | QUEEN CITY GYMNASTICS |
Entity Type: | Organization |
Organization Name: | QUEEN CITY GYMNASTICS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR/OCCUPATIONAL THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RACHEL |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | LOTT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTD, OTR/L, BCP |
Authorized Official - Phone: | 513-489-7575 |
Mailing Address - Street 1: | 7900 E KEMPER RD |
Mailing Address - Street 2: | |
Mailing Address - City: | CINCINNATI |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45249-1616 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 513-489-7575 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7900 E KEMPER RD |
Practice Address - Street 2: | |
Practice Address - City: | CINCINNATI |
Practice Address - State: | OH |
Practice Address - Zip Code: | 45249-1616 |
Practice Address - Country: | US |
Practice Address - Phone: | 513-489-7575 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | QUEEN CITY GYMNASTICS |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2021-02-25 |
Last Update Date: | 2021-02-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Single Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Single Specialty |
No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Single Specialty |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Single Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health | Group - Single Specialty |
No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | Group - Single Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Single Specialty | |
No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Single Specialty |