Healthcare Provider Details

I. General information

NPI: 1508937608
Provider Name (Legal Business Name): MS. VERONICA MARANAN DELEON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5232 BROADVIEW RD
RICHFIELD OH
44286-9481
US

IV. Provider business mailing address

6703 HIDDEN LAKE TRL
BRECKSVILLE OH
44141-3189
US

V. Phone/Fax

Practice location:
  • Phone: 330-659-4161
  • Fax:
Mailing address:
  • Phone: 440-838-1721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA. 03627
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: