Healthcare Provider Details

I. General information

NPI: 1245585603
Provider Name (Legal Business Name): REHAB EDUCATORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BAKER BLVD SUITE 4
FAIRLAWN OH
44333-3674
US

IV. Provider business mailing address

50 BAKER BLVD SUITE 4
FAIRLAWN OH
44333-3674
US

V. Phone/Fax

Practice location:
  • Phone: 330-801-4308
  • Fax:
Mailing address:
  • Phone: 330-801-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number3324
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number3324
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number3324
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number3324
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3324
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code225XR0403X
TaxonomyDriving and Community Mobility Occupational Therapist
License Number3324
License Number StateOH
# 7
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3324
License Number StateOH

VIII. Authorized Official

Name: MARY JOHANNA MCGUIRE
Title or Position: ADMINISTRATOR
Credential: MS, OTR/L
Phone: 330-620-3502