Mariam Boulos, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT013024 Issued in OH

Practice address

50 Baker Blvd Ste 4
Fairlawn, OH 44333-3635

Phone

(330) 801-4308

NPI assigned

Sep 6, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rehab Educators, LLC

  • Occupational Therapist
  • Fairlawn, OH
  • NPI 1245585603
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1508691684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4778 BARN HILL DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443331692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BAKER BLVD STE 4",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333635",
            "telephone_number": "330-801-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "MARIAM",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT013024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley Booher
• Jeffrey Jay Borodkin, O.D.
• Kayla Boros
• Elon Bortz
• Ashley Bosserman
• Dina Youseff Boutros, M.D.
• Deborah Mitchell Bowe, M.D.
• Kiara Bowens
• Keriayna Boyer
• Destani Boykin

• Occupational Therapist in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.