Provider Demographics
NPI:1770802084
Name:COYLE, EILEEN M (OTR/L)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:COYLE
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 1:2364 BECKET CIR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-7023
Mailing Address - Country:US
Mailing Address - Phone:508-873-3791
Mailing Address - Fax:
Practice Address - Street 1:563 COLONY PARK DR
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2859
Practice Address - Country:US
Practice Address - Phone:330-634-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006787225X00000X
MA3210225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist