Provider Demographics
NPI:1720840234
Name:HERMES, ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HERMES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7608 STATE ROUTE 101 E APT A
Mailing Address - Street 2:
Mailing Address - City:CASTALIA
Mailing Address - State:OH
Mailing Address - Zip Code:44824-9617
Mailing Address - Country:US
Mailing Address - Phone:419-202-1139
Mailing Address - Fax:
Practice Address - Street 1:5000 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-1410
Practice Address - Country:US
Practice Address - Phone:419-843-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT010145225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist