MEDICARE: MS. JACQUELINE SUE FRABELL OTL,CHT

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	225XH1200X	Hand Occupational Therapist	OT002664	OH
2	225X00000X	Occupational Therapist	OT002664	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12077852	OTHER	OH	CAQH

General Provider Information

NPI Number	:	1386850196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JACQUELINE SUE FRABELL OTL,CHT

Provider Business Mailing Address
First Line	:	5000 ROCKSIDE RD STE 500
Second Line	:
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2178
Country	:	US
Telephone Number	:	216-459-2846
Fax Number	:	216-901-2803

Provider Business Practice Location Address
First Line	:	11925 PEARL RD STE 202
Second Line	:
City	:	STRONGSVILLE
State	:	OH
Zip	:	44136-3343
Country	:	US
Telephone Number	:	440-238-0300
Fax Number	:	440-238-0750

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	03/10/2017

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