MEDICARE: MS. LYNN MARIE SCHAFER OTRL

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	OT2409	OH

General Provider Information

NPI Number	:	1447326277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNN MARIE SCHAFER OTRL

Provider Business Mailing Address
First Line	:	369 EAST 250TH STREET
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44132
Country	:	US
Telephone Number	:	440-725-2539
Fax Number	:	216-791-1101

Provider Business Practice Location Address
First Line	:	1909 EAST 101ST STREET
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-791-8118
Fax Number	:	216-791-1101

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	07/08/2007

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