Provider Demographics
NPI:1407448848
Name:KLIMCZYK, ASHLEY LYNN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:KLIMCZYK
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 1:3287 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-1923
Mailing Address - Country:US
Mailing Address - Phone:216-339-2660
Mailing Address - Fax:
Practice Address - Street 1:387 GOLFVIEW LN STE 150
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-4428
Practice Address - Country:US
Practice Address - Phone:216-282-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011291225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist