MEDICARE: CHARLOTTE HARRIS

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	2273	OH

General Provider Information

NPI Number	:	1407239981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE HARRIS

Provider Business Mailing Address
First Line	:	15624 HAZEL RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-2905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15624 HAZEL RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-2905
Country	:	US
Telephone Number	:	216-466-1757
Fax Number	:

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

Provider Enumeration Date	:	07/02/2015
Last Update Date	:	07/02/2015

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Directions to “ CHARLOTTE HARRIS ” Practice Location

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