Provider Demographics
NPI:1720589302
Name:LACERVA, DIANNE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:LACERVA
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 1:7917 MEGAN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4536
Mailing Address - Country:US
Mailing Address - Phone:440-668-8446
Mailing Address - Fax:
Practice Address - Street 1:2132 CASE PKWY STE A
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2383
Practice Address - Country:US
Practice Address - Phone:330-963-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand