Provider Demographics
NPI:1073635447
Name:KEECH DOHERTY, VANESSA LYNN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:LYNN
Last Name:KEECH DOHERTY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5865 ALDERSON ST
Mailing Address - Street 2:APT. 11
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2460
Mailing Address - Country:US
Mailing Address - Phone:412-537-9140
Mailing Address - Fax:
Practice Address - Street 1:1401 HAMILTON RD
Practice Address - Street 2:ST. FRANCIS ACADEMY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-2364
Practice Address - Country:US
Practice Address - Phone:412-884-5227
Practice Address - Fax:412-884-7420
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008583225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist