MEDICARE: MS. CHARLENE KOTULA 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	OC003595L	PA

General Provider Information

NPI Number	:	1972771442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHARLENE KOTULA OTR/L

Provider Business Mailing Address
First Line	:	200 NORTHPOINTE CIR
Second Line	:	ROOM 302
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046-7861
Country	:	US
Telephone Number	:	412-680-6500
Fax Number	:	412-380-1351

Provider Business Practice Location Address
First Line	:	200 NORTHPOINTE CIR
Second Line	:	ROOM 302
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046-7861
Country	:	US
Telephone Number	:	412-680-6500
Fax Number	:	412-380-1351

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

Provider Enumeration Date	:	02/18/2008
Last Update Date	:	02/18/2008

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