Provider Demographics
NPI:1083210900
Name:DICIANO, ABIGAIL E (OTR/L)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:E
Last Name:DICIANO
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 1:336 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:PA
Mailing Address - Zip Code:17517-1721
Mailing Address - Country:US
Mailing Address - Phone:717-336-0168
Mailing Address - Fax:
Practice Address - Street 1:336 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:PA
Practice Address - Zip Code:17517-1721
Practice Address - Country:US
Practice Address - Phone:717-336-0168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017350225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation