Provider Demographics
NPI:1962943654
Name:GERHARDT, ROSEMARIE (OTA)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:GERHARDT
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:
Other - Last Name:RAAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTA
Mailing Address - Street 1:7223 MAUMEE WESTERN RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9755
Mailing Address - Country:US
Mailing Address - Phone:419-865-0251
Mailing Address - Fax:419-724-3353
Practice Address - Street 1:7223 MAUMEE WESTERN RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9755
Practice Address - Country:US
Practice Address - Phone:419-865-0251
Practice Address - Fax:419-724-3353
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA000463224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant