Individual
MARY TADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10700 MONTGOMERY RD, SUITE 125, CINCINNATI, OH 45242-3255
(513) 489-5300
Mailing address
10700 MONTGOMERY RD, SUITE 125, CINCINNATI, OH 45242-3255
(513) 489-5300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.00641
OH
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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