Individual
MRS. AMY MARIE NOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5520 BROADVIEW RD, PARMA, OH 44134-1605
(216) 749-6650
(216) 749-1655
Mailing address
24806 KENNEDY RIDGE RD, NORTH OLMSTED, OH 44070-3469
(216) 225-0149
(216) 901-2803
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005376
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000603850
ANTHEM BLUE CROSS AND BLUE SHEILD
OH
01
—
12075740
CAQH
OH
05
—
3158461
—
OH
Enumeration date
07/28/2009
Last updated
12/02/2015
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