MEDICARE: PATRICIA ANDRICH OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	225X00000X	Occupational Therapist	OH
2	225XN1300X	Neurorehabilitation Occupational Therapist
3	225XP0200X	Pediatric Occupational Therapist	OH

General Provider Information

NPI Number	:	1962742338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ANDRICH OTR/L

Provider Business Mailing Address
First Line	:	10139 ROYALTON RD
Second Line	:	SUITE D
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4472
Country	:	US
Telephone Number	:	440-230-0923
Fax Number	:	440-786-5086

Provider Business Practice Location Address
First Line	:	10139 ROYALTON RD
Second Line	:	SUITE D
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4472
Country	:	US
Telephone Number	:	440-230-0923
Fax Number	:	440-786-5086

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

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	02/22/2013

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