Provider Demographics
NPI:1396956546
Name:PORTER, KAREN (OTR)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:PORTER
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 1:25221 MILES RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5474
Mailing Address - Country:US
Mailing Address - Phone:216-514-1600
Mailing Address - Fax:216-292-3291
Practice Address - Street 1:25221 MILES RD
Practice Address - Street 2:SUITE F
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5474
Practice Address - Country:US
Practice Address - Phone:216-514-1600
Practice Address - Fax:216-292-3291
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003552225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics