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NPI Code Detail

MEDICARE: DANIELLE KATHRYN ALDER OTR/L

MEDICARE: DANIELLE KATHRYN ALDER OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOC006444LPA

General Provider Information

NPI Number : 1396098331
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE KATHRYN ALDER OTR/L
Provider Business Mailing Address
First Line : 71 LINCOLN AVE
Second Line :
City : WEST WYOMING
State : PA
Zip : 18644-1307
Country : US
Telephone Number : 570-855-4501
Fax Number :
Provider Business Practice Location Address
First Line : 500 SCHOOL ST
Second Line :
City : CLARKS SUMMIT
State : PA
Zip : 18411-1508
Country : US
Telephone Number : 570-586-3587
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2012
Last Update Date : 10/15/2012

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