MEDICARE: CAITLYN BONHAG OTR/L

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	OT009715	OH

General Provider Information

NPI Number	:	1558891903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN BONHAG OTR/L

Provider Business Mailing Address
First Line	:	9198 DARROW RD
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-1856
Country	:	US
Telephone Number	:	330-486-2048
Fax Number	:

Provider Business Practice Location Address
First Line	:	9198 DARROW RD
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-1856
Country	:	US
Telephone Number	:	330-486-2048
Fax Number	:

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

Provider Enumeration Date	:	06/18/2017
Last Update Date	:	02/07/2024

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