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General NPI Number Information
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NPI Number | 1710682216
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Entity Type | Individual
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Provider Name | LAURA MACKELLAR OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 28550 WESTLAKE VILLAGE DR
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City | WESTLAKE
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State | OH
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Zip | 44145-7608
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Country | US
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Telephone | 420-044-0892
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Fax |
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Provider Business Mailing Address
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Address Line | 6065 ORCHARD HILL BLVD
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City | LORAIN
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State | OH
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Zip | 44053-3867
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Country | US
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Telephone | 440-396-3565
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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 | OT008722
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License Number State | OH
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