MEDICARE: MRS. CAITLIN KEMPF CLEVER MOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OC012820	PA

General Provider Information

NPI Number	:	1033511233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAITLIN KEMPF CLEVER MOT, OTR/L

Provider Business Mailing Address
First Line	:	5510 STANTON AVE
Second Line	:	APT. 3
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-2036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5510 STANTON AVE
Second Line	:	APT. 3
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-2036
Country	:	US
Telephone Number	:	412-328-3591
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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