Provider Demographics
NPI:1467275875
Name:UHLS, MARY ELIZABETH (COTA/L)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:UHLS
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 1:1110 MEADOWSWEET DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45315-7730
Mailing Address - Country:US
Mailing Address - Phone:937-903-9333
Mailing Address - Fax:
Practice Address - Street 1:911 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-9520
Practice Address - Country:US
Practice Address - Phone:937-456-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA008494224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant