Provider Demographics
NPI:1801155254
Name:TREADWAY, AMELIA CELESTE (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:AMELIA
Middle Name:CELESTE
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:AMELIA
Other - Middle Name:CELESTE
Other - Last Name:OPPERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15618 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8507
Mailing Address - Country:US
Mailing Address - Phone:937-444-5214
Mailing Address - Fax:
Practice Address - Street 1:3995 COTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1680
Practice Address - Country:US
Practice Address - Phone:513-563-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.04961224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant