Provider Demographics
NPI:1487722872
Name:MINOR, CHERYL L (OTR,L RYT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:MINOR
Suffix:
Gender:F
Credentials:OTR,L RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 HIGH VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9224
Mailing Address - Country:US
Mailing Address - Phone:330-336-3052
Mailing Address - Fax:
Practice Address - Street 1:1130 HIGH VIEW DR
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9224
Practice Address - Country:US
Practice Address - Phone:330-336-3052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 003505225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist