Provider Demographics
NPI:1396034666
Name:NISCHWITZ, ANNA M (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:NISCHWITZ
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 1:4017 CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9347
Mailing Address - Country:US
Mailing Address - Phone:330-518-7148
Mailing Address - Fax:
Practice Address - Street 1:211 REDONDO RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1805
Practice Address - Country:US
Practice Address - Phone:330-744-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant