=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962166132
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RHIANNON M PILLER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2021
-----------------------------------------------------
Last Update Date | 10/25/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 MARKET AVE N
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44702-1083
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-456-1014
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10037 W SPRAGUE RD
-----------------------------------------------------
City | NORTH ROYALTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44133-1216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-610-9518
-----------------------------------------------------
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 | OT011763
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------