MEDICARE: MRS. CELIE JEANETTE HILL COTA/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA-01228	OH

General Provider Information

NPI Number	:	1154370997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CELIE JEANETTE HILL COTA/L

Provider Business Mailing Address
First Line	:	3836 E 149TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3836 E 149TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-1104
Country	:	US
Telephone Number	:	216-921-1286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/08/2007

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