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General NPI Number Information
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NPI Number | 1417172685
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Entity Type | Individual
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Provider Name | BRANDI ANN SCHIAVONE MS OTRL
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Gender | Female
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Dates
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Enumeration Date | 04/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 915 DELAWARE ST
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City | FOREST CITY
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State | PA
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Zip | 18421-1005
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Country | US
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Telephone | 570-785-3390
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Fax | 570-785-3937
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Provider Business Mailing Address
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Address Line | RR 1 BOX 1194
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City | CARBONDALE
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State | PA
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Zip | 18407-9031
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Country | US
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Telephone | 570-222-2439
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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 | OC007009L
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License Number State | PA
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