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General NPI Number Information
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NPI Number | 1063203966
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Entity Type | Individual
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Provider Name | HANNAH MICHELLE SHUCK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 150 N MILLER RD STE 150A
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City | FAIRLAWN
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State | OH
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Zip | 44333-3713
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Country | US
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Telephone | 330-867-2240
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Fax |
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Provider Business Mailing Address
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Address Line | 5992 CHURCHILL WAY
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City | MEDINA
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State | OH
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Zip | 44256-6340
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Country | US
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Telephone | 330-421-2591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT013230
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License Number State | OH
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