MEDICARE: CYNTHIA RAKOW 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	225XP0200X	Pediatric Occupational Therapist	OT- 003677	OH

General Provider Information

NPI Number	:	1922558410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA RAKOW OTR/L

Provider Business Mailing Address
First Line	:	2662 KEMPER RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1534
Country	:	US
Telephone Number	:	216-712-2967
Fax Number	:

Provider Business Practice Location Address
First Line	:	2662 KEMPER RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1534
Country	:	US
Telephone Number	:	216-712-2967
Fax Number	:

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

Provider Enumeration Date	:	10/07/2016
Last Update Date	:	01/27/2017

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