Provider Demographics
NPI:1194063933
Name:SCHWEIZER, TRACI (COTA/L)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:
Last Name:SCHWEIZER
Suffix:
Gender:F
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 1:5516 WADSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3750
Mailing Address - Country:US
Mailing Address - Phone:419-410-2508
Mailing Address - Fax:
Practice Address - Street 1:3600 BUTZ RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9691
Practice Address - Country:US
Practice Address - Phone:419-867-7926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.03146224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant