MEDICARE: MS. CRISTINE SUTTER OCCUPATIONAL THERAPI

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.002153	OH

General Provider Information

NPI Number	:	1871951087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CRISTINE SUTTER OCCUPATIONAL THERAPI

Provider Business Mailing Address
First Line	:	856 W COOK RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-5012
Country	:	US
Telephone Number	:	419-525-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	856 W COOK RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-5012
Country	:	US
Telephone Number	:	419-525-6400
Fax Number	:

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

Provider Enumeration Date	:	02/02/2016
Last Update Date	:	02/02/2016

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