Provider Demographics
NPI:1093421851
Name:HORVATH, ALYSSA JEAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JEAN
Last Name:HORVATH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 WESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1979
Mailing Address - Country:US
Mailing Address - Phone:330-808-2211
Mailing Address - Fax:
Practice Address - Street 1:8301 TALLMADGE RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-9231
Practice Address - Country:US
Practice Address - Phone:330-654-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT012238225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist