MEDICARE: MS. JENNIFER NEIL HARLAND BA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT-5935	OH

General Provider Information

NPI Number	:	1205936713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER NEIL HARLAND BA

Provider Business Mailing Address
First Line	:	1528 SUNVIEW RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2839
Country	:	US
Telephone Number	:	440-605-0867
Fax Number	:

Provider Business Practice Location Address
First Line	:	14900 PRIVATE DR
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-3413
Country	:	US
Telephone Number	:	216-851-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/08/2007

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