Healthcare Provider Details

I. General information

NPI: 1356744197
Provider Name (Legal Business Name): FRANCESCA MARIE WALDRON I MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HART PL
CARBONDALE PA
18407-1593
US

IV. Provider business mailing address

10 HART PL
CARBONDALE PA
18407-1593
US

V. Phone/Fax

Practice location:
  • Phone: 570-282-1020
  • Fax:
Mailing address:
  • Phone: 570-282-1020
  • Fax: 570-282-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC012714
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: