Healthcare Provider Details

I. General information

NPI: 1629996285
Provider Name (Legal Business Name): NATALIE WOLF OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 PECK RD
MANTUA OH
44255-9505
US

IV. Provider business mailing address

10600 PECK RD
MANTUA OH
44255-9505
US

V. Phone/Fax

Practice location:
  • Phone: 330-221-7634
  • Fax:
Mailing address:
  • Phone: 330-221-7634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT013790
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: