Provider Demographics
NPI:1720115587
Name:COMRIE, ELIZABETH LOUISE (OTRL)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:COMRIE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LOUISE
Other - Last Name:BAKALAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:6666 STONE RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-3523
Mailing Address - Country:US
Mailing Address - Phone:440-590-1804
Mailing Address - Fax:
Practice Address - Street 1:16706 CHILLICOTHE RD STE 700
Practice Address - Street 2:LIFESPAN LEARNING COMMUNITIES
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4573
Practice Address - Country:US
Practice Address - Phone:440-708-2219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-5034225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist