Healthcare Provider Details

I. General information

NPI: 1407251895
Provider Name (Legal Business Name): KAREN HAUPTMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31500 ROYALVIEW DR
WILLOWICK OH
44095-4256
US

IV. Provider business mailing address

10732 BLUEBERRY HILL DR
KIRTLAND OH
44094-5502
US

V. Phone/Fax

Practice location:
  • Phone: 440-944-3130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number002469
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: