=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265315410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHERINE ELIZABETH WOCKLEY PTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3590 WASHINGTON PIKE
-----------------------------------------------------
City | BRIDGEVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15017-1286
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-257-2472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 106 FIELDSTONE CT
-----------------------------------------------------
City | VENETIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15367-2332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-288-3534
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | TE013821
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------