Provider Demographics
NPI:1154627214
Name:CESTARI, BRITTANNIE LAINE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:BRITTANNIE
Middle Name:LAINE
Last Name:CESTARI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:BRITTANNIE
Other - Middle Name:LAINE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5156 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2663
Mailing Address - Country:US
Mailing Address - Phone:330-478-1752
Mailing Address - Fax:330-478-1763
Practice Address - Street 1:5156 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2663
Practice Address - Country:US
Practice Address - Phone:330-478-1752
Practice Address - Fax:330-478-1763
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 007659225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3055563Medicaid
OH3055563Medicaid