Provider Demographics
NPI:1336556836
Name:RODDY, RONALD LEN (COTA/L)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:LEN
Last Name:RODDY
Suffix:
Gender:M
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 1:1500 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2510
Mailing Address - Country:US
Mailing Address - Phone:513-631-6800
Mailing Address - Fax:531-531-7013
Practice Address - Street 1:1500 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2510
Practice Address - Country:US
Practice Address - Phone:513-631-6800
Practice Address - Fax:531-531-7013
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA02722174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist