Provider Demographics
NPI:1659028017
Name:UKWELA, JEMIMA (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:JEMIMA
Middle Name:
Last Name:UKWELA
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11610 MCCRACKEN RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2845
Mailing Address - Country:US
Mailing Address - Phone:216-744-5094
Mailing Address - Fax:
Practice Address - Street 1:1349 E 79TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-2864
Practice Address - Country:US
Practice Address - Phone:216-744-5094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011882225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist