MEDICARE: HANNAH COON OTD, 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	OT012025	OH

General Provider Information

NPI Number	:	1619682242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH COON OTD, OTR/L

Provider Business Mailing Address
First Line	:	6200 LANDERHAVEN DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-4129
Country	:	US
Telephone Number	:	440-566-0163
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 LANDERHAVEN DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-4129
Country	:	US
Telephone Number	:	440-566-0163
Fax Number	:

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

Provider Enumeration Date	:	01/18/2023
Last Update Date	:	12/06/2025

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