Provider Demographics
NPI:1225353360
Name:SANTO, KEZIA DARLENE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KEZIA
Middle Name:DARLENE
Last Name:SANTO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:KEZIA
Other - Middle Name:DARLENE
Other - Last Name:SANTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:2929 KIDDS SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9677
Mailing Address - Country:US
Mailing Address - Phone:610-223-3303
Mailing Address - Fax:
Practice Address - Street 1:998 S RUSSELL ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3542
Practice Address - Country:US
Practice Address - Phone:717-718-9908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1001863225200000X
PAOC008926225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant