Mylene Mort, OTA
Individual provider Active NPI Occupational Therapy Assistant · Berlin, PA
NPI 1417020652 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1417020652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OP001290L (PA)
- Practice address
- 1404 Hay St
Berlin, PA 15530-1455 - Phone
- (814) 267-4212
- Fax
- (814) 267-6213
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP001290L | PA | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OP001290L | PA | Yes |
Addresses
Primary practice location
1404 Hay St
Berlin, PA 15530-1455
Mailing address
2346 Plank Rd
Hooversville, PA 15936-7617
Phone (814) 893-5523
Other names
- Miss Mylene Henry
Other providers in Berlin, PA
- Jay Michael Kennedy
- Glenn Wayne Kreinbrook
- Michelle Kush
- Cheng-Wei Liu
- Amy Mackanick
- Ruth A Shaffer
- Somerset Care Inc.
- Borut Spehar
- Helen Thompson
- Kenneth J Vanantwerp
All providers in Berlin, PA · Occupational Therapy Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.