Basic Information
| Provider Information | |||||||||
| NPI: | 1639319874 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILOTA | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | CARRIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 529 WATERFORD CT | ||||||||
| Address2: | |||||||||
| City: | AVON LAKE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440122356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402403040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 551 W LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | HAVERFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190411419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105254000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2009 | ||||||||
| LastUpdateDate: | 02/28/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 004743 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.