Provider Demographics
NPI:1326705948
Name:TOBIAS, TEAUNA MONAE (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:TEAUNA
Middle Name:MONAE
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 E 176TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-3110
Mailing Address - Country:US
Mailing Address - Phone:216-501-8864
Mailing Address - Fax:
Practice Address - Street 1:3151 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1757
Practice Address - Country:US
Practice Address - Phone:216-321-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH005222224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty