MEDICARE: MRS. MINI THOMAS 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
1	225X00000X	Occupational Therapist	OC010262	PA

General Provider Information

NPI Number	:	1972754539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MINI THOMAS OTR/L

Provider Business Mailing Address
First Line	:	235 W LANCASTER AVE
Second Line	:
City	:	DEVON
State	:	PA
Zip	:	19333-1560
Country	:	US
Telephone Number	:	610-688-8080
Fax Number	:

Provider Business Practice Location Address
First Line	:	283 LANCASTER AVE
Second Line	:
City	:	MALVERN
State	:	PA
Zip	:	19355-3089
Country	:	US
Telephone Number	:	734-308-6608
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	03/19/2026

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