Provider Demographics
NPI:1801886767
Name:FIGHTMASTER, MARIE E (OT)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:FIGHTMASTER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6031
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45270-6031
Mailing Address - Country:US
Mailing Address - Phone:513-557-4270
Mailing Address - Fax:513-557-3214
Practice Address - Street 1:560 SOUTH LOOP RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-301-5600
Practice Address - Fax:859-301-5669
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT004089225XH1200X
KY4089225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8800052600Medicaid
KYP00263059Medicare PIN
KY8800052600Medicaid