Healthcare Provider Details

I. General information

NPI: 1124447404
Provider Name (Legal Business Name): MS. DIANE SATURNINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 MARTIN LUTHER KING JR DR
CLEVELAND OH
44104-3815
US

IV. Provider business mailing address

11755 LEGEND CREEK DR
CHESTERLAND OH
44026-1659
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 440-668-5761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT000590
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: