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NPI Code Detail

MEDICARE: MRS. KATHRYN LUCY DEDIONISIO COOPER MSOT, OTR/L

MEDICARE: MRS. KATHRYN LUCY DEDIONISIO COOPER MSOT, 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
1225X00000XOccupational TherapistOT012512OH

General Provider Information

NPI Number : 1811847759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHRYN LUCY DEDIONISIO COOPER MSOT, OTR/L
Provider Business Mailing Address
First Line : 1460 DOLPHIN WAY
Second Line :
City : ERIE
State : PA
Zip : 16509-7608
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 158 W MAIN RD
Second Line :
City : CONNEAUT
State : OH
Zip : 44030-2039
Country : US
Telephone Number : 440-593-0356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2026
Last Update Date : 01/30/2026

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