Basic Information
| Provider Information | |||||||||
| NPI: | 1831631209 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEAR | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | REAGAN | ||||||||
| OtherFirstName: | MAUREEN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5646 CANTERBURY RD | ||||||||
| Address2: | |||||||||
| City: | NORTH OLMSTED | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440704518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405204893 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5868 STUMPH RD | ||||||||
| Address2: | |||||||||
| City: | PARMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441301736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408885407 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2016 | ||||||||
| LastUpdateDate: | 11/16/2016 | ||||||||
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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 | OT005429 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.