MEDICARE: MIRANDA MLINCEK OTD

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	225X00000X	Occupational Therapist	OT012487	OH

General Provider Information

NPI Number	:	1245186881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA MLINCEK OTD

Provider Business Mailing Address
First Line	:	51 CANTERBURY CIR
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-2093
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26908 DETROIT RD STE 300
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-2399
Country	:	US
Telephone Number	:	440-414-6050
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ MIRANDA MLINCEK OTD” Practice Location

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