Provider Demographics
NPI:1194938829
Name:BARAONA, AMY (PT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:BARAONA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 PARKLANE DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3423
Mailing Address - Country:US
Mailing Address - Phone:440-886-3271
Mailing Address - Fax:
Practice Address - Street 1:551 E WASHINGTON ST
Practice Address - Street 2:SUITE 108
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4403
Practice Address - Country:US
Practice Address - Phone:440-542-6850
Practice Address - Fax:440-542-6859
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist