Healthcare Provider Details

I. General information

NPI: 1932474699
Provider Name (Legal Business Name): TOYA M HINES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 S BROAD ST
PHILADELPHIA PA
19145-2328
US

IV. Provider business mailing address

810 W PENN PINES BLVD
ALDAN PA
19018-4311
US

V. Phone/Fax

Practice location:
  • Phone: 215-339-4563
  • Fax:
Mailing address:
  • Phone: 610-394-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC008690
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOC008690
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOC008690
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: