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General NPI Number Information
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NPI Number | 1992454342
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Entity Type | Individual
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Provider Name | SHEA MCCANN MS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 3570 WARRENSVILLE CENTER RD STE 106
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-5226
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Country | US
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Telephone | 216-282-1582
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Fax | 216-927-1801
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Provider Business Mailing Address
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Address Line | 3818 JOHN AVE
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City | CLEVELAND
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State | OH
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Zip | 44113-3208
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Country | US
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Telephone | 207-660-5715
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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 | OT012089
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License Number State | OH
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