Provider Demographics
NPI:1639261274
Name:DAVIS, MARIA-ELENA O (OT)
Entity Type:Individual
Prefix:
First Name:MARIA-ELENA
Middle Name:O
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ERIE CT
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1724
Mailing Address - Country:US
Mailing Address - Phone:440-984-2416
Mailing Address - Fax:440-984-2422
Practice Address - Street 1:150 ERIE CT
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1724
Practice Address - Country:US
Practice Address - Phone:440-984-2416
Practice Address - Fax:440-984-2422
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT5871225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7255198Medicaid
OH7255198Medicaid