Provider Demographics
NPI:1619525672
Name:MEYERS, ELISE M (OTR/L)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:M
Last Name:MEYERS
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 1:2 HOMEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2411
Mailing Address - Country:US
Mailing Address - Phone:419-921-6365
Mailing Address - Fax:
Practice Address - Street 1:2 HOMEWOOD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2411
Practice Address - Country:US
Practice Address - Phone:419-921-6365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHO009988225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist