Basic Information
Provider Information
NPI: 1851978050
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CEDDIA
FirstName: ABIGAIL
MiddleName:  
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Credential:  
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Mailing Information
Address1: 4314 COURAGEOUS CIR
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452521985
CountryCode: US
TelephoneNumber: 5137068814
FaxNumber:  
Practice Location
Address1: 779 GLENDALE MILFORD RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452151161
CountryCode: US
TelephoneNumber: 5137711779
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2021
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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