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General NPI Number Information
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NPI Number | 1093040164
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Entity Type | Organization
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Legal Business Name | MARYANN BUTCHKO OT PLLC
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 200 ASHELAND AVE SUITE 200B
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City | ASHEVILLE
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State | NC
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Zip | 28801-4016
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Country | US
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Telephone | 828-242-4410
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Fax |
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Provider Business Mailing Address
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Address Line | 200 ASHELAND AVE SUITE 200B
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City | ASHEVILLE
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State | NC
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Zip | 28801-4016
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Country | US
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Telephone | 828-242-4410
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARYANN BUTCHKO
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Credential | OT
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Telephone | 828-242-4410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 5436
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5436
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License Number State | NC
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