Healthcare Provider Details

I. General information

NPI: 1619682242
Provider Name (Legal Business Name): HANNAH COON OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8353 MENTOR AVE STE 10
MENTOR OH
44060-5700
US

IV. Provider business mailing address

8353 MENTOR AVE STE 10
MENTOR OH
44060-5700
US

V. Phone/Fax

Practice location:
  • Phone: 440-636-4533
  • Fax:
Mailing address:
  • Phone: 440-636-4533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT012025
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: