Individual
ELISABETH BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
10011 EUCLID AVE, CLEVELAND, OH 44106-4701
(217) 791-8363
Mailing address
10011 EUCLID AVE, CLEVELAND, OH 44106-4701
(217) 791-8363
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA03862
OH
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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