Healthcare Provider Details

I. General information

NPI: 1285940874
Provider Name (Legal Business Name): CYNTHIA J WISWESSER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK WEST BLVD SUITE 270
AKRON OH
44320
US

IV. Provider business mailing address

1420 SHARBROOK DR
WADSWORTH OH
44281-9413
US

V. Phone/Fax

Practice location:
  • Phone: 330-564-4100
  • Fax:
Mailing address:
  • Phone: 330-334-3703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT003377
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: