MEDICARE: TARA KRALL OTR/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	225X00000X	Occupational Therapist	OT-4627	OH

General Provider Information

NPI Number	:	1497179048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA KRALL OTR/L

Provider Business Mailing Address
First Line	:	6451 CENTER ST
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5028 FOREST RD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-1308
Country	:	US
Telephone Number	:	440-257-5951
Fax Number	:

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

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	09/16/2021

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Directions to “ TARA KRALL OTR/L” Practice Location

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