Provider Demographics
NPI:1972698363
Name:SZABLICKI, ELZBIETA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:ELZBIETA
Middle Name:
Last Name:SZABLICKI
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 1:3626 RIDGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2042
Mailing Address - Country:US
Mailing Address - Phone:440-746-9313
Mailing Address - Fax:
Practice Address - Street 1:5520 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-1605
Practice Address - Country:US
Practice Address - Phone:216-749-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA. 03501224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant