Provider Demographics
NPI:1306174776
Name:HARGER, MARY T (COTA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:T
Last Name:HARGER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4037 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2736
Mailing Address - Country:US
Mailing Address - Phone:216-346-7166
Mailing Address - Fax:
Practice Address - Street 1:4037 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2736
Practice Address - Country:US
Practice Address - Phone:216-346-7166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA. 02239224Z00000X
FLOTA 11118224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant