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General NPI Number Information
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NPI Number | 1326467481
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Entity Type | Individual
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Provider Name | SUZANNE HART OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 15600 PARKLAND DR
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-2529
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Country | US
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Telephone | 216-295-5717
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Fax |
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Provider Business Mailing Address
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Address Line | 19234 WINSLOW RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-4950
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Country | US
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Telephone | 216-773-0203
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT 003208
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License Number State | OH
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