Provider Demographics
NPI:1841562642
Name:MALONEY, OLIVIA NOELLE (COTA/L)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:NOELLE
Last Name:MALONEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 LAUBY AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3634
Mailing Address - Country:US
Mailing Address - Phone:330-724-5665
Mailing Address - Fax:
Practice Address - Street 1:680 LAUBY AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3634
Practice Address - Country:US
Practice Address - Phone:330-724-5665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04852224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant