Provider Demographics
NPI:1528858149
Name:ETTER, GODJUST (CPRS)
Entity type:Individual
Prefix:
First Name:GODJUST
Middle Name:
Last Name:ETTER
Suffix:
Gender:X
Credentials:CPRS
Other - Prefix:
Other - First Name:SEVVRIN
Other - Middle Name:
Other - Last Name:OHTAKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8044 MONTGOMERY RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2919
Mailing Address - Country:US
Mailing Address - Phone:513-607-5128
Mailing Address - Fax:
Practice Address - Street 1:8044 MONTGOMERY RD STE 120
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2919
Practice Address - Country:US
Practice Address - Phone:513-607-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist