Healthcare Provider Details

I. General information

NPI: 1952218117
Provider Name (Legal Business Name): RACHEL JANE PURACCHIO COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BETA DR STE 300
MAYFIELD OH
44143-2377
US

IV. Provider business mailing address

7424 CAROLE DR
MENTOR OH
44060-5717
US

V. Phone/Fax

Practice location:
  • Phone: 216-417-4748
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA006451
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: