Healthcare Provider Details

I. General information

NPI: 1760875439
Provider Name (Legal Business Name): HILARY MEALE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HILARY SMITH

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 07/14/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3109 UNIVERSITY AVE SELLARO PLAZA C
MORGANTOWN WV
26505-3205
US

IV. Provider business mailing address

4325 RTE 51N
ROSTRAVER TWP PA
15012-3535
US

V. Phone/Fax

Practice location:
  • Phone: 304-241-4020
  • Fax:
Mailing address:
  • Phone: 724-565-5806
  • Fax: 724-483-0290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1760
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC013474
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: