Provider Demographics
NPI:1649689647
Name:STEPHENS, JANICE LEE (COTA)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:LEE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N ERIE HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4263
Mailing Address - Country:US
Mailing Address - Phone:513-887-3710
Mailing Address - Fax:
Practice Address - Street 1:400 N ERIE HWY
Practice Address - Street 2:SUITE A
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-4263
Practice Address - Country:US
Practice Address - Phone:513-887-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.03214224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant