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General NPI Number Information
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NPI Number | 1275444549
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Entity Type | Individual
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Provider Name | MARY KATE FARRELL
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Gender | Female
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 370 WHITESTONE COR
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City | STROUDSBURG
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State | PA
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Zip | 18360-7193
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Country | US
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Telephone | 570-476-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 121 RIVER ST
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City | JESSUP
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State | PA
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Zip | 18434-1213
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Country | US
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Telephone | 570-677-3708
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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 | OC021719
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License Number State | PA
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