Mary Lee Boesewetter, OTR/L
Individual provider Active NPI Occupational Therapist · Independence, OH
NPI 1205844404 · NPPES record last updated Nov 24, 2015
Key facts
- NPI
- 1205844404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT000492 (OH)
- Practice address
- 5000 Rockside Rd Ste 500
Independence, OH 44131-2178 - Phone
- (216) 459-2846
- Fax
- (216) 901-2803
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT000492 | OH | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT000492 | OH | Yes |
Addresses
Primary practice location
5000 Rockside Rd Ste 500
Independence, OH 44131-2178
Mailing address
1396 Bobby LN
Westlake, OH 44145-1985
Phone (440) 808-9209
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0842995 | Medicaid | OH | |
| 11576182 | Other | OH | CAQH |
| 000000217474 | Other | OH | ANTHEM BLUE CROSS AND BLU |
Other providers in Independence, OH
- Kelsey Christine Blatt
- Erma Blunt-Bennett
- Barbara Holland Bobal
- Karolina Boc
- Brianna Bockman Wu
- Jada Boggan
- Eric William Boose
- David James Bound
- Sarah Bound
- Minnie M Bowers
All providers in Independence, OH · Occupational Therapist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.