Provider Demographics
NPI:1225379993
Name:STADLER, DIANA (OT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:STADLER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BALA PLZ
Mailing Address - Street 2:SUITE IL-47
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1501
Mailing Address - Country:US
Mailing Address - Phone:610-668-1048
Mailing Address - Fax:610-668-9539
Practice Address - Street 1:2 BALA PLZ
Practice Address - Street 2:SUITE IL-47
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-668-1048
Practice Address - Fax:610-668-9539
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist