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NPI Code Detail

MEDICARE: MRS. AIMEE MARISSA O'HARA OTR

MEDICARE: MRS. AIMEE MARISSA O'HARA OTR
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
1225X00000XOccupational TherapistOC007622LPA

General Provider Information

NPI Number : 1568588820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AIMEE MARISSA O'HARA OTR
Provider Business Mailing Address
First Line : 316 LOGAN AVE
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-1112
Country : US
Telephone Number : 215-884-9079
Fax Number :
Provider Business Practice Location Address
First Line : 2 FRANKLIN TOWN BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1238
Country : US
Telephone Number : 215-563-1800
Fax Number : 215-575-9437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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