Healthcare Provider Details

I. General information

NPI: 1568003168
Provider Name (Legal Business Name): MORGAN PETROFF OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 DENTZLER RD
PARMA OH
44134-4961
US

IV. Provider business mailing address

7377 CHATEAU DR
PARMA OH
44130-6000
US

V. Phone/Fax

Practice location:
  • Phone: 440-842-5300
  • Fax:
Mailing address:
  • Phone: 440-842-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: