Healthcare Provider Details

I. General information

NPI: 1821139767
Provider Name (Legal Business Name): KRISTIN HARDING OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN BRUCKER OTR/L

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 ROUTE 130 UNIT B
IRWIN PA
15642-1617
US

IV. Provider business mailing address

12245 SEDONA DR
NORTH HUNTINGDON PA
15642-8798
US

V. Phone/Fax

Practice location:
  • Phone: 724-374-4104
  • Fax:
Mailing address:
  • Phone: 412-849-4322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC005711L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: