Provider Demographics
NPI:1881042810
Name:ERDMANN, KIARA KAYE (OTR)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:KAYE
Last Name:ERDMANN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CHESAPEAKE CT
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-4514
Mailing Address - Country:US
Mailing Address - Phone:920-285-6385
Mailing Address - Fax:
Practice Address - Street 1:16600 W SPRAGUE RD STE 365
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-6319
Practice Address - Country:US
Practice Address - Phone:216-820-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.009360225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist