Mallory McBreen, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OP006641 Issued in PA

Practice address

2200 1St Ave
Pottsville, PA 17901-2065

Phone

(570) 628-6950

Fax

(570) 628-4874

NPI assigned

Dec 4, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1386889475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 1ST ST",
            "city": "PORT CARBON",
            "state": "PA",
            "postal_code": "179651637",
            "telephone_number": "570-292-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 1ST AVE",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012065",
            "telephone_number": "570-628-6950",
            "fax_number": "570-628-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBREEN",
        "first_name": "MALLORY",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP006641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE LICENSE",
            "identifier": "OP006641",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maternal & Family Health Services, Inc.
• Glady Mary Mathew, MD
• Zachary Matuzsan, DO
• Joseph Matz, M.D.
• Gabrielle Elizabeth Maxwell, PA-C
• Angela Ann McCabe, OTRL
• Kathy E McCaw, MA
• Sue Lynn McCormick, CRNP
• Leeann McDermott, CRNP
• Lynne McGovern

• Occupational Therapy Assistant in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Occupational Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.