Provider Demographics
NPI:1033364229
Name:DIPAOLO, KRISTA D (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:D
Last Name:DIPAOLO
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1740
Mailing Address - Country:US
Mailing Address - Phone:215-957-1499
Mailing Address - Fax:
Practice Address - Street 1:48 CHASE AVE
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-1740
Practice Address - Country:US
Practice Address - Phone:215-815-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009359225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics