=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376762930
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARJORIE CASES OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2007
-----------------------------------------------------
Last Update Date | 10/06/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 W CHESTER PIKE SUITE 1B
-----------------------------------------------------
City | HAVERTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19083-5315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-449-3580
-----------------------------------------------------
Fax | 610-449-3584
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 316 PRITCHARD LN
-----------------------------------------------------
City | WALLINGFORD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19086-6105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-566-3937
-----------------------------------------------------
Fax | 610-566-3937
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OC008937
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number | OC008937
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------