Provider Demographics
NPI:1295616175
Name:SLACK, MARAH LEE
Entity type:Individual
Prefix:DR
First Name:MARAH
Middle Name:LEE
Last Name:SLACK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 BRODHEAD RD STE 150
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2793
Mailing Address - Country:US
Mailing Address - Phone:724-510-3464
Mailing Address - Fax:724-419-4380
Practice Address - Street 1:2719 BRODHEAD RD STE 150
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2793
Practice Address - Country:US
Practice Address - Phone:724-510-3464
Practice Address - Fax:724-419-4380
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist