Healthcare Provider Details

I. General information

NPI: 1851221642
Provider Name (Legal Business Name): METTA PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SANCTUARY DR
CORTLAND OH
44410-8816
US

IV. Provider business mailing address

330 SANCTUARY DR
CORTLAND OH
44410-8816
US

V. Phone/Fax

Practice location:
  • Phone: 330-219-3179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JASMIN PHILLIPS
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 330-219-3179