Healthcare Provider Details

I. General information

NPI: 1669504080
Provider Name (Legal Business Name): BARRIE G. GALVIN, OTR L & ASSOCIATES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25221 MILES RD SUITE F
CLEVELAND OH
44128-5474
US

IV. Provider business mailing address

25221 MILES RD SUITE F
CLEVELAND OH
44128-5474
US

V. Phone/Fax

Practice location:
  • Phone: 216-514-1600
  • Fax:
Mailing address:
  • Phone: 216-514-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARRIE G GALVIN
Title or Position: MANAGING MEMBER/OWNER
Credential: OTR L
Phone: 216-514-1600