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NPI Code Detail

MEDICARE: MS. MONICA AURELIA WALLS OTRL

MEDICARE: MS. MONICA AURELIA WALLS OTRL
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
1225XG0600XGerontology Occupational TherapistOT005713OH
2225XP0019XPhysical Rehabilitation Occupational TherapistOC002055LPA

General Provider Information

NPI Number : 1710216551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MONICA AURELIA WALLS OTRL
Provider Business Mailing Address
First Line : 1790 WOODSIDE DR
Second Line :
City : HERMITAGE
State : PA
Zip : 16148-1679
Country : US
Telephone Number : 724-342-2518
Fax Number :
Provider Business Practice Location Address
First Line : 520 S NEW CASTLE ST
Second Line :
City : NEW WILMINGTON
State : PA
Zip : 16142-1446
Country : US
Telephone Number : 724-946-3511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2009
Last Update Date : 12/07/2009

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Directions to “ MS. MONICA AURELIA WALLS OTRL” Practice Location

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