Provider Demographics
NPI:1679396980
Name:BENDER, MARIAH FAITH (COTA)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:FAITH
Last Name:BENDER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2981 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-8529
Mailing Address - Country:US
Mailing Address - Phone:234-650-9197
Mailing Address - Fax:
Practice Address - Street 1:9370 UNION CEMETERY RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-9577
Practice Address - Country:US
Practice Address - Phone:513-677-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA008742224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant