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General NPI Number Information
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NPI Number | 1760776751
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Entity Type | Individual
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Provider Name | MOIRA CLEARY OT
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Gender | Female
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 15765 STATE ROUTE 170 STE 2
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9600
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Country | US
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Telephone | 330-386-5252
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Fax | 330-386-3555
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Provider Business Mailing Address
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Address Line | 15765 STATE ROUTE 170 STE 2
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9600
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Country | US
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Telephone | 330-386-5252
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Fax | 330-386-3555
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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 | OT003356
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License Number State | OH
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