Provider Demographics
NPI:1750369187
Name:GRUHOT, CYNTHIA A (OTR/L,CHT,CLT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:GRUHOT
Suffix:
Gender:F
Credentials:OTR/L,CHT,CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 TREBEIN RD
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-8581
Mailing Address - Country:US
Mailing Address - Phone:937-478-4210
Mailing Address - Fax:937-320-0050
Practice Address - Street 1:1100 BROWN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2601
Practice Address - Country:US
Practice Address - Phone:937-478-4210
Practice Address - Fax:866-272-1218
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT005568225X00000X
OHSM.067646225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4100631Medicare PIN