Provider Demographics
NPI:1700602489
Name:BECHERUCCI, JILL MARIE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:BECHERUCCI
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 CODDINGVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8485
Mailing Address - Country:US
Mailing Address - Phone:330-419-9496
Mailing Address - Fax:
Practice Address - Street 1:150 N MILLER RD STE 150A
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3713
Practice Address - Country:US
Practice Address - Phone:330-867-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT013139225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist