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General NPI Number Information
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NPI Number | 1184122459
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Entity Type | Individual
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Provider Name | MARIAH SCHUSTER SCHICK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 721 STEDMAN ST
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City | KETCHIKAN
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State | AK
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Zip | 99901-6632
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Country | US
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Telephone | 907-225-7825
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Fax |
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Provider Business Mailing Address
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Address Line | 8278 S TONGASS HWY
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City | KETCHIKAN
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State | AK
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Zip | 99901-9763
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Country | US
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Telephone | 406-314-0299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 174089
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 60824409
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License Number State | WA
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