Provider Demographics
NPI:1073601985
Name:STAUB, MARIA BETH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:BETH
Last Name:STAUB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5871 GROVELAND STATION RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-9767
Mailing Address - Country:US
Mailing Address - Phone:585-658-4023
Mailing Address - Fax:
Practice Address - Street 1:7059 STANDPIPE RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:NY
Practice Address - Zip Code:14530-9616
Practice Address - Country:US
Practice Address - Phone:585-237-2230
Practice Address - Fax:585-237-5949
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017313-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist