=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740794023
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAUREN ASHLEY SZYMCZYK OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2017
-----------------------------------------------------
Last Update Date | 12/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6455 PEARL RD
-----------------------------------------------------
City | PARMA HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44130-2984
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-888-5900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 93 WHEELOCK DR
-----------------------------------------------------
City | BEDFORD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44146-3733
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-408-1785
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT009729
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------