=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891590634
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIANNE FABER MOTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2025
-----------------------------------------------------
Last Update Date | 02/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4701 BAPTIST RD
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15227-1117
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-334-4790
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4607 LIBRARY RD SUITE 220, BOX 433
-----------------------------------------------------
City | BETHEL PARK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15102-6909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-735-4117
-----------------------------------------------------
Fax | 412-388-1194
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number | OC009117
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------