Provider Demographics
NPI:1528008984
Name:ACCESS LIFE THERAPIES, LLC
Entity Type:Organization
Organization Name:ACCESS LIFE THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OCCULATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:614-436-0174
Mailing Address - Street 1:718 WORTHINGTON WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-5713
Mailing Address - Country:US
Mailing Address - Phone:614-436-0174
Mailing Address - Fax:614-776-5622
Practice Address - Street 1:718 WORTHINGTON WOODS BLVD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-5713
Practice Address - Country:US
Practice Address - Phone:614-436-0174
Practice Address - Fax:614-776-5622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1382264174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAC9351181Medicare ID - Type UnspecifiedMEDICARE GROUP UPIN