Healthcare Provider Details

I. General information

NPI: 1598221889
Provider Name (Legal Business Name): NATALIE ANN TITUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9108 STATE HIGHWAY 198
CONNEAUTVILLE PA
16406-2646
US

IV. Provider business mailing address

494 MCCULLOUGH RD
SHARPSVILLE PA
16150-3326
US

V. Phone/Fax

Practice location:
  • Phone: 814-587-2012
  • Fax:
Mailing address:
  • Phone: 724-926-6286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: