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Individual

GRATIA MICHELLE KOVATCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
7947 TARTAN FIELDS DR, DUBLIN, OH 43017-8778
(937) 620-0018
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
286056
KY
224Z00000X
Occupational Therapy Assistant
Primary
OTA005909
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201735659
OH
05
286056
KY
Enumeration date
06/06/2023
Last updated
10/19/2023
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