Provider Demographics
NPI:1487075495
Name:SWANGER, CHERYL ELIZABETH (COTA/L)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELIZABETH
Last Name:SWANGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 N UNION ST
Mailing Address - Street 2:APT 2
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-1251
Mailing Address - Country:US
Mailing Address - Phone:419-543-1917
Mailing Address - Fax:
Practice Address - Street 1:1600 CRIDER RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-9268
Practice Address - Country:US
Practice Address - Phone:419-589-7611
Practice Address - Fax:419-589-3430
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00133247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other