Provider Demographics
NPI:1285688671
Name:BUTCHKO, MARYANN (OT)
Entity Type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:
Last Name:BUTCHKO
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 1:200 ASHELAND AVE
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4016
Mailing Address - Country:US
Mailing Address - Phone:828-242-4410
Mailing Address - Fax:828-257-2032
Practice Address - Street 1:200 ASHELAND AVE
Practice Address - Street 2:SUITE 200B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4016
Practice Address - Country:US
Practice Address - Phone:828-242-4410
Practice Address - Fax:828-257-2032
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5436174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC137X9OtherBC/BS
NC2510860Medicare PIN