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General NPI Number Information
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NPI Number | 1104236736
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Entity Type | Individual
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Provider Name | NANCY MCCAULEY
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 111 GOODRICH CT
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City | CHARDON
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State | OH
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Zip | 44024-1215
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Country | US
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Telephone | 440-285-4067
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Fax |
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Provider Business Mailing Address
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Address Line | 470 CENTER ST BLDG 8
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City | CHARDON
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State | OH
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Zip | 44024-1071
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | .05675
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License Number State | OH
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