Healthcare Provider Details

I. General information

NPI: 1134492317
Provider Name (Legal Business Name): JESSICA L FARKAS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5531 CHAPPELL CROSSING BLVD
WEST CHESTER OH
45069-5226
US

IV. Provider business mailing address

339 E MAPLE ST
NORTH CANTON OH
44720-2593
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 330-498-8239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT. 007977
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: